Women Physicians 19th Century

Out of the Dead House
OUT OF THE
DEAD HOUSE
Nineteenth-Century Women Physicians
and the Writing of Medicine
Susan Wells
THE UNIVERSITY OF WISCONSIN PRESS

The University of Wisconsin Press
2537 Daniels Street
Madison, Wisconsin 53718
3 Henrietta Street
London WC2E 8LU, England
Copyright 䉷 2001
The Board of Regents of the University of Wisconsin System
All rights reserved
1 3 5 4 2
Printed in the United States of America
Library of Congress Cataloging-in-Publication Data

Wells, Susan.
Out of the dead house : nineteenth-century women physicians
and the writing of medicine / Susan Wells.
324 pp. cm.
Includes bibliographical references and index.
ISBN 0-299-17170-1 (cloth: alk. paper)
ISBN 0-299-17174-4 (pbk.: alk. paper)
1. Women physicians—United States. 2. Preston, Ann, 1813–1872.
3. Jacobi, Mary Putnam, 1842–1906. 4. Longshore, Hannah, 1819–1901.
5. Women in medicine—United States—History—19th century. I. Title.
R692 .W45 2001
610⬘.82⬘097309034—dc21 00-010614
for
Laura Rose Grady
and
Constance Claire Grady
Darling,
stand still at your door,
sure of yourself, a white stone, a good stone—
as exceptional as laughter, you will strike fire,
that new thing!
Anne Sexton
Contents
Illustrations ix
Acknowledgments xi
1 Out of the Dead House 3
2 Medical Conversations and Medical Histories 16
3 Invisible Writing I: Ann Preston Invents an Institution 57
4 Learning to Write Medicine 80
5 Invisible Writing II: Hannah Longshore and the Borders
of Regularity 122
6 Mary Putnam Jacobi: Medicine as Will and Idea 146
7 Forbidden Sights: Women and the Visual Economy
of Medicine 193
Notes 229
Works Cited 280
Index 307
vii
Illustrations
1 Title page of Dr. Rebecca Lee Crumpler’s Book of
Medical Discourses (1883) 52
2 Letter from Rebecca Crumpler to “Mrs. Stone” 55
3 Ann Preston, M.D., ca. 1850 60
4 Page 20 of Frances G. Mitchell’s thesis (1851), showing
corrections probably made by her preceptor, Francis X.
McCloskey 112
5 Caroline Still Wiley Anderson, 1868 114
6 Eliza Grier, from her 1898 class picture 115
7 A portion of Hannah E. Longshore’s autobiographical
speech, first version 135
speech, second version 136
speech, final version 137
10 Hannah E. Longshore, portrait, 1897 143
11 Mary Putnam Jacobi, 1860–65 154
12 Woodcut from Mary Putnam Jacobi’s “Studies in
Endometritis” 187
13 Thomas Eakins’s The Agnew Clinic, unveiled at
the University of Pennsylvania on May 1, 1889,
to commemorate Agnew’s retirement 210
14 Sylvia Hatton (WMC 1899) with “Chimmie Fadden,” her
nicknamed skeleton, 1895–96 213
15 Elizabeth Wray-Howell, M.D., Mary Montgomery Marsh,
M.D., Grace Shermerhorn, M.D., and Laura Hills, M.D.,
graduates of the Woman’s Medical College of
Pennsylvania, class of 1896 214
16 Student group photograph in anatomy laboratory, 1897 216
ix
Illustrations
17 The Human Body and the Library as Sources of

Knowledge, illustration for Johann Adam Kulmus’s
Tabulae anatomicae, Amsterdam, 1732 220
18 Woman student from the Woman’s Medical College of the
New York Infirmary dissecting a leg, 1870 221
x
Acknowledgments
Nineteenth-century women physicians could be a sociable group; working on
their writing put me in touch with new and hospitable worlds of medical his-
tory and medical archives and confirmed my connections with rhetoricians
and compositionists. Karyn Hollis’s chance remark that she would love to see
the materials at the Medical College of Pennsylvania’s archives prompted me
to visit there; Theresa Taylor, most patient of archivists, gave me a list of
basic historical books and put Hannah Longshore’s papers into my hands. I
owe immense debts to her and her successors at the Archives and Special
Collections on Women in Medicine, especially Barbara Williams, who sus-
tained the archive through a chaotic period in the history of the college and
who supplied me richly from its immense resources. This book has also ben-
efited from the help of archivists and librarians at the Friends Historical
Library, the Center for the Study of the History of Nursing, the Historic
Library of the Pennsylvania Hospital, the Thomas Jefferson University Ar-
chives, the Quaker Collection of the Haverford College Library, the Rare
Book and Manuscript Library at the University of Pennsylvania, the Schle-
singer Library at Radcliffe College, the Historical Library at the National
Library of Medicine in Washington, D.C., the Library of the College of
Physicians of Philadelphia, the Temple University Urban Archives, and the
Charles L. Blockson Afro-American Collection at Temple University. In
using these archival materials, I preserved original spelling, grammar, and
punctuation.
Participants at academic conferences asked especially useful questions
about this project. I am grateful to the College Composition and Communi-
cation Conference, the Pennsylvania State University Conference on Com-
position and Rhetoric, the Wayne State University American Studies Collo-
quium, the Wood Seminars in the History of Medicine at the College of
Physicians of Philadelphia, the American Association for the History of Med-
icine, the Modern Language Association, the Kent State English Graduate
Organization, and the Partial Bodies Conference sponsored by graduate stu-
dents in comparative literature at the University of Pennsylvania. The ques-
xi
Acknowledgments
tions and comments of James Bono and Gretchen Worden have been espe-
cially memorable and welcome. The University of Pennsylvania Workshop
in the History and Sociology of Science and Technology offered me a bench-
mark for rigorous reflection on the aims of science studies. And I owe a
more sustained debt to the students and auditors in my seminar Feminist
Rhetorics of Science and to Robert Caserio, who complied with my unrea-
sonable request for a late change of seminar topic. My colleagues in rhetoric
and composition at Temple University—Eli Goldblatt, Dennis Lebofsky, Ar-
abella Lyon, Frank Sullivan, and Steve Parks—tolerated my urgent requests
to look at the latest gruesome pictures. Sally Mitchell and Miles Orvell told
me things about archival work that I should have learned in graduate school.
Maurice Vogel and Gretchen Condon, scholars in the history and sociology
of medicine at Temple, helped me locate my work in relation to those chal-
lenging and fascinating fields. Steven Peitzman, author of A New and Un-
tried Course: Woman’s Medical College and the Medical College of Pennsyl-
vania (Rutgers University Press, 2000), a critically important history of the
Woman’s Medical College, and Michael Sappol, author of A Traffic of Dead
Bodies: Anatomy and Embodied Social Identity in Nineteenth Century
America, a compelling account of dissection and the formation of American
medicine (Princeton University Press, 2001), have been generous and help-
ful colleagues; I have gained immeasurably from dialogue with them. All
errors are my own.
I am grateful for support from Temple University, especially a Summer
Research Grant, two Grants-in-Aid of Research, and a Research and Study
Leave, without which I would not have finished this book. I owe special
thanks to Mary Elizabeth Braun and to the University of Wisconsin Press
referees, whose advice has been invaluable, and to Rachel Bright, who did
final proofreading.
The lines on the dedication page are from Anne Sexton’s “Little Girl, My
String Bean, My Lovely Woman.”
Finally, I am grateful to Hugh Grady, and to Laura Rose Grady and Con-
stance Claire Grady, for their love and support, and for the “large liberty”
that sustained this book.
xii
1

In 1840, the ten-year-old Marie Zakrzewska was living at La Charité, the
Berlin midwifery school. Her mother had obtained special permission to en-
ter the school, usually closed to married women, and Marie was permitted
to join her when the girl’s weak eyes needed treatment. (Marie’s father, a
man of “liberal opinions,” “impetuous temperament,” and “revolutionary
tendencies,” had been dismissed from his military officer’s commission with
an insufficient pension; Marie’s mother needed to help support the family.)
Marie made rounds, her eyes bandaged, with her physician, Dr. Müller, who
called her his “little blind doctor.” 1 She listened to what he said with great
concentration.
When the bandages were removed, Dr. Müller told Marie that the corpse
of a young man who had been poisoned and turned green was in the dead
house, the building that was the hospital’s morgue and pathology laboratory.
Marie went there to look for herself, and while relatives were busy with the
young man’s body, she toured the nearby rooms: “These were all freshly
painted. The dissecting tables, with the necessary apparatus, stood in the
center, while the bodies, clad in white gowns, were ranged on boards along
the walls. I examined everything, came back, and looked to my heart’s con-
tent at the poisoned young man.” Then she noticed that both the relatives
and the caretaker were gone and that the building was locked. Marie looked
through all the rooms again, knocked on the door for half an hour, gave up,
and went to sleep. Well after dark, Marie’s mother found her, “sitting close
by [the door] on the floor fast asleep.” 2 A few days later, Dr. Müller gave
Marie the History of Midwifery and the History of Surgery, which she read
through the six weeks of her summer vacation.
This story rehearses one of the narratives of nineteenth-century women’s

entry into medicine. The protagonist comes to us as a little girl, curious,
unafraid, strangely concentrated, usually accompanied by her mother and
almost always by someone who acts as her father. She learns what she can,
3
but then faces an obstacle. She has wandered far from her place, but she has
not yet arrived where she wants to be. She is, as far as she knows, fearless.
Zakrzewska, in her version of this story, comes to a place that is actively
forbidden, the dead house. She comes in search of a magical sight—a man
who has changed color, like a victim of enchantment. The dead house is not
for her a place of loss or mourning but a domain of almost festive order.
There, the girl who has spent weeks only listening can now also look. And so
she looks, for as long as she wants. She would rather not sleep all night there
by herself, but if she must, she will.
Rescued, she sees clearly and claims medical knowledge for herself. She
takes up her books and reads, beginning a medical education that will bring
her to the United States, to a long collaboration with Elizabeth Blackwell, to
an honored place as “Dr. Zak” in the histories of the New England Hospital
for Women and Children and the New England Female Medical College.
Before beginning her education as a physician, Zakrzewska did a lifetime’s
work: she kept house for her large family, nursed relatives, and assisted in
her mother’s midwifery practice until she was twenty. Admitted to midwifery
school, she was soon assistant to the teacher—her own Dr. Müller. She lec-
tured to the class and then took examinations on her lectures, and she was
appointed chief of the school on her graduation. When she heard that a
woman had become a doctor in the United States, she immigrated, support-
ing herself with a small worsted business, and finally contacted Elizabeth
Blackwell. When she entered medical school in Cleveland, her father wrote
that if she had been a young man, “I could not find words in which to express
my satisfaction and pride in respect to your acts; for I know that all you
accomplish you owe to yourself: but you are a woman, a weak woman; and
all that I can do for you now is to grieve and weep.” At one point, Zakrzewska
was so dismayed by her father’s disapproval that she decided to go as a mis-
sionary to “civilize the squaws.” 3 But she persevered, graduated, and eventu-
ally prospered.
Zakrzewska tells her story in a singular but representative voice—rational,
humorous, willing to indulge in sentimentality but not to forgo satire. For
Dr. Zak, that voice was grounded in the study and practice of science, a
practice that “has no sex.” 4 Knowing as we do that medicine not only deals
with gendered bodies but also in some ways genders the bodies it treats, we
would not make such a statement today. But we might also recover, in an act
of historical imagination, the force of such a statement, for Zakrzewska and
women like her. Medicine offered them not only the possibility of a wider
sphere but the possibility of a world without spheres, where the house of the
dead had been set in order, and there was nothing to be afraid of. Like many
other women physicians, Zakrzewska was cured by medical knowledge: Ann
Preston, Mary Putnam Jacobi, and Hannah Longshore, three early graduates
4
of the Woman’s Medical College of Pennsylvania, all felt sure that by becom-
ing physicians they had saved their lives, delivered themselves from con-
finement and uselessness, permitted themselves to use their strength and
talents. The letters of nineteenth-century women physicians include both
complaints of overwork or poor health and professions of a singular joy in
the work they were able to do, the lives they had imagined into existence.
The work of medicine included reading and writing, beginning for Za-
krzewska with those two fat histories. Later, she would become a writer her-
self: with the help of a loose association of Cleveland feminists, Zakrzewska
wrote her thesis in English and went on to produce proposals, articles, letters
to official bodies, lectures, and magazine and publicity pieces.5 In fact, every
woman physician wrote a thesis; many continued to write on scientific topics.
Women physicians did the writing that characterized the emerging pro-
fession: case histories, faculty minutes, public lectures, commencement
speeches, scientific papers, political arguments, memoirs, and testimonies to
investigative bodies. Their work is perhaps the largest corpus of scientific
writing by women before the contemporary period. As medical practice
emerged and organized itself in the United States, women physicians con-
structed a textual representation of medicine, developing the emerging
norms of the medical interview, testing the limits of internal criticism of the
profession, inventing new forms of medical research. Sometimes celebrated
and sometimes marginalized, they participated in the early production of
professional medical writing. I am tempted to speculate that these women
wrote an alternate medicine, that their texts are sketches for a possible sci-
ence that never came into being. Instead, I advance a more modest claim:
that women physicians did the work of medicine as it was understood in the
last half of the nineteenth century, and that their writing can historicize and
complicate our understanding of the relations among women and science,
gender and knowledge.
Women physicians developed distinctive strategies for speaking and writ-
ing in a hostile profession. Many wrote as if they were men of the received
order: they insisted on the regularity of their medical views and the rigor of
their education. These women sometimes argued for a wider sphere for
women or claimed that their gender gave them a special understanding of
some neglected (and usually undervalued) aspect of medicine, such as hy-
giene, public health, or prevention. Theirs was a strategy of masquerade: the
woman physician wrote as male but did not present herself as “a man.” In-
stead, she was “a doctor as good as any man”; her disguise is foregrounded
as a performance, rendered memorable by the special skill she brought to it.6
Other women were quite willing to foreground their gender, to use it as a
tool for transforming medicine. Such women were often interested in irregu-
lar therapies, such as the water cure, mesmerism, and magnetism; they were
5
active in radical causes, including abolition, women’s rights, dress reform,

and temperance movements. Rather than writing conventional medicine,
women who adopted this strategy sought to transform the nature of medical
writing; they often wrote for a broad audience, popularizing medical knowl-
edge as they saw it, lectured, and wrote in radical journals. Their perfor-
mance of the discourse of medicine was, in a broad sense, travesty—a per-
formance of subversion dressed as compliance.
Women physicians at the end of the century expanded the range of pos-
sible gender performances: the woman physician offered herself as a scien-
tist, able to discourse about the body like a philosopher, accountable to the
highest standards of rigor. She could fulfill, as much as it was ever to be
fulfilled, the promise of Zakrzewska’s motto, “Science has no sex.” But of
course, such a relentless female performance of a discourse configured as
male was not uninflected: the woman physician who wrote “normal medi-
cine” was in some sense cross-dressing as male.7 Individual women physi-
cians adopted various combinations of these strategies at different times
during their careers and hoped for a variety of responses from their profes-
sion—from transformation to benign neglect. Seeing gender as a perfor-
mance helps us to appreciate the rhetorical skill of these women physicians
and their uses of the slender rhetorical resources available to them.
THE CONTEXT: NINETEENTH-CENTURY MEDICINE

AND WOMEN PHYSICIANS
Late nineteenth-century medicine is paradigmatic of successful profes-

sionalization: doctors gained control of licensing, training, and disciplining
procedures and also expanded exponentially the range of conditions and
diseases they could treat successfully.8 In 1800, only two hospitals were op-
erating in the United States. The range of conditions for which no effective
treatment was available could supply several seasons of television medical
series plots: typhoid fever, yellow fever, typhus, influenza, appendicitis, most
cancers, many forms of heart disease, diabetes, tuberculosis. Surgery con-
centrated on the treatment of wounds and the repair of fractures; textbooks
in surgery devoted more space to amputations than to any other opera-
tion. Medicine included a wide range of therapeutic disciplines: regular (or,
for homeopaths, “allopathic”) medicine, homeopathy, magnetic and electri-
cal treatments (including mesmerism), the water cure, steam treatments,
botanicals, hybrid disciplines such as Eclecticism, and self-treatment sys-
tems such as Thompsonianism. Some of these disciplines still survive; others,
like magnetic appliances, the Thompsonian recipe books for herbal medi-
cines that allowed every man to be his own doctor, and the apparatus for
6
steam treatments, clutter the backrooms of medical archives. But in the mid-
nineteenth century, these disciplines were plausible competitors with regu-
lar medicine: Eclecticism, which drew on both the allopathic and homeo-
pathic pharmacopeias, sponsored several medical schools and was powerful
within a number of midwestern medical societies. Medical practice had been
deregulated at the beginning of the century: licenses were not required to
practice medicine; charters were freely given to proprietary medical schools.
From its formation in 1846, the American Medical Association struggled to
establish the hegemony of regular medicine over these disparate schools and
to bring hospitals and medical schools under the control of the profession.
So dazzling was the association’s success that it is difficult for us to imagine
the contingency and openness of nineteenth-century medicine, let alone to
maintain the relativism that informs contemporary work in the rhetoric of
science.
We think of medical education as proverbially grueling, but in the middle
of the nineteenth century, a physician enjoyed an easier professional prepa-
ration than, say, a minister, who in some congregations was expected to mas-
ter demanding ancient languages and perplexing questions of theology. The
aspiring medical student needed no prior formal education, although he was
expected to know enough Latin to write prescriptions. Before reforms estab-
lished entrance standards in the third quarter of the century, the sole re-
quirement for entry into medical school was a year’s preceptorship with an
established physician. The medical student heard seven courses of lectures
given over a four-month term by practicing physicians who lectured as a side-
line. The student repeated the same course a second year, wrote a thesis,
and passed an oral examination. It is not surprising that the standard history
of nineteenth-century medical education begins with the sentence, “A cen-
tury ago, being a medical student in America was easy.” 9
The ease of medical school was not necessarily good news for patients,
but it was certainly good news for women who wanted a medical education.
Opening a proprietary medical school—and, at midcentury, most American
schools were proprietary—required only classrooms, a rudimentary library,
and the part-time services of seven physicians; after applying for a state char-
ter, the school could enroll students and grant medical degrees. At midcen-
tury, a number of women’s schools were founded, usually with scanty initial
support. In 1848, in order to protect women’s modesty by training female
midwives, Samuel Gregory founded the school that would become the New
England Female Medical College. The Woman’s (originally Female) Medi-
cal College of Pennsylvania, founded by a group of Philadelphia Quakers,
graduated eight women in its first class in 1851. (The name was changed in
1867; the school is referred to consistently as the Woman’s Medical College
in this book.) A handful of women, such as Elizabeth Blackwell, graduated
7
from male medical schools or, like her sister Emily, found a medical educa-
tion abroad. Coeducation, the goal of many women physicians, came slowly;
the University of Michigan became coeducational in 1870, and forty-eight
women graduated from the Howard University medical department be-
tween 1869 and 1900.10 But women’s main point of entry into the medi-
cal profession was the women’s proprietary school, including, besides the
schools in Boston, New York, and Philadelphia, women’s medical colleges in
Chicago and Baltimore and smaller schools in Atlanta, St. Louis, Cincinnati,
and Toronto. By 1898, these colleges enrolled 377 students. Over five thou-
sand women were practicing as regular physicians in the United States, most
of them in New York, Pennsylvania, Massachusetts, Maryland, Illinois, and
California—they constituted about 5 percent of the medical profession, a
percentage that was not surpassed until the 1970s.11 These women formed a
cadre of scientific workers. They met in women’s medical societies, corres-
ponded through their school’s alumnae associations, and carried out active
careers as clinicians, teachers, and researchers.
Women medical students, like male medical students, came from the
middle and upper-middle classes,12 but they faced financial challenges that
differed from those of male medical students. Although many enjoyed the
support of their families, especially of physician fathers, others battled famil-
ial hostility. Many came late to medical school—in 1880, the average gradu-
ate at the Woman’s Medical College of Pennsylvania was twenty-seven.13
Women might enter medical school after a sojourn in teaching or nursing or
after fulfilling family obligations to care for sick relatives. And women medi-
cal students often worked during medical school or interrupted their educa-
tion to earn money.
Women doctors, their supporters, their opponents, and their patients were
all convinced that women physicians practiced a different kind of medicine
from that offered by male physicians at the middle of the nineteenth century.
Usually, this difference is described in quietist terms: women doctors were
less interventionist, less likely to prescribe harsh drugs or surgery, and more
empathetic. But Regina Markell Morantz-Sanchez’s study comparing the
woman-run New England Hospital with the male-run Boston Lying-In dur-
ing the 1880s and 1890s revealed “no significant divergence between the
two hospitals regarding infant mortality or maternal outcome.” 14 There were
minor differences in treatment. Patients at New England Hospital were al-
ways given a systemic fortifying prescription, such as “beef tea,” while such
prescriptions were less frequent at Boston Lying-In. New England Hospital
kept much more detailed records of its patients. But every other significant
variable, including the rate of forceps deliveries and success in controlling
sepsis, shows no difference between treatment at the two hospitals. At
the last quarter of the nineteenth century, women doctors were practicing
8
a quite conventional style of medicine, with no more and no less success

than male doctors. But it was, paradoxically, quite common for all sorts of
nineteenth-century physicians to feel that their practices were distinct and
innovative, even if their therapies were well within common practice.15 Con-
temporaneous accounts of women physicians, quite logically, emphasized
what was distinct in their practice; why write about what was unremarkable?
Women physicians, therefore, worked in a social context in which their prac-
tice was seen as distinctly feminine but in which their therapeutic choices
were very similar to those of men.
The period during which women physicians formed a distinct and cohe-
sive group came to an end with the rise of coeducation and the professional-
ization of medical schools following the Flexner report in 1910.16 The Johns
Hopkins Medical School was planned, during its development in the 1880s,
on the German model: it would have a full-time faculty, its own teaching
hospital, and an orientation to both research and clinical training. Such a
school was both unprecedented and extremely expensive, and its opening
was delayed from year to year. The Woman’s Fund Committee raised the
final five hundred thousand dollars needed to open the school and offered
these funds to the trustees if they would admit women on the same terms as
men. Hopkins opened with a coeducational class in 1893; within five years,
most medical schools were open to women. Enrollments at the women’s col-
leges fell from 459 in 1893 to 183 in 1904, and many schools closed.17 The
Flexner report (1910), sponsored by the AMA Committee on Medical Edu-
cation, proposed a general reform of medical education, including more clin-
ical and laboratory work, the development of a professional faculty, and insti-
tutional connections with teaching hospitals. The weakened women’s schools
were unable to implement these reforms. In Keith Ludmerer’s words, “Of
all the oppressed groups, women suffered the most ironic setback. In the
wake of the Flexner report, all but one women’s medical college [the Wom-
an’s Medical College of Pennsylvania] closed.” 18
The success of coeducation as a strategy for training women physicians
was uncertain. Some schools discontinued the admission of women; very few
admitted women at rates higher than 5 percent. Very few of the women who
had taught at women’s medical colleges joined the faculties of co-ed schools;
the intellectual infrastructure that women physicians had enjoyed lost im-
portant institutional supports. The number of women medical students actu-
ally declined from 1,280 in 1902 to 992 in 1926. The proportion of women
in the profession reached 6 percent in 1910 and then shrank steadily until
1950; it did not rise dramatically until the 1970s.19
Women’s participation in nineteenth-century medicine, then, was uneven
and contradictory: women entered a large, loose profession in relatively
ample numbers, participated in its work as it developed scientifically, formed
9
their own institutions, were accepted into the male institutions as scientific
medicine achieved its greatest triumphs, and then were both marginalized
and dispersed. Advances for women physicians were not necessarily signifi-
cant for women patients; advances for women patients could be setbacks for
women physicians. Early women physicians told quite diverse stories about
themselves; they saw themselves as pioneers of medicine of material care
and placed their own work in a context we can recover only in fragments.
One of the imaginative possibilities that nineteenth-century women physi-
cians can suggest to us is that of a less absolute triumph of regular medicine,
of multiple and intersecting medical practices.
WOMEN PHYSICIANS AND SCIENCE STUDIES
This book is not a medical history but an intervention into the rhetoric of
science. Rhetoric of science analyzes how scientific texts, including the dis-
courses of medicine, constitute social practices and knowledges. A rhetorical
study of the discourses of medicine shows that ways of writing and talking
about the body supported doctors’ and patients’ understandings of gender,
of race, indeed of embodiment in general.20 And the relation between those
understandings and the material practices they supported, practices studied
by feminist historians, can tell us how texts shape other kinds of scientific
work. In the case of nineteenth-century medicine, women physicians partici-
pated in both scientific discourses and scientific practices. As medicine be-
came professionalized, it portrayed itself as masculine, as an uncompromis-
ing search for truth and certainty rather than a project of feminine comfort
or care; we need not ourselves participate in that ideology, although we, un-
like Zakrzewska, have good reason to think of science as male. In both its
subject matter and its institutional practices, medicine has been a gendered
science, and the first wave of feminist scholarship passionately dismantled
its claim to neutral objectivity, analyzing how medicine constructed gender
and how the masculine bias of the profession compromised both its ability
to treat women patients and its claim to impartiality.21 At the same time,
feminist scholarship in education and psychology, especially Carol Gilligan’s
In a Different Voice and Mary Belenky and her associates’ Women’s Ways of
Knowing, suggested that the continued underrepresentation of women in
the sciences was connected to the masculine bias of science education.22 In
the conventional science class, these studies claim, the student is evoked
as an isolated, rather than a connected, knower. Belenky and her associates
characterized such isolation as more comfortable for men than for women
students. Further challenges were mounted by feminist philosophers of sci-
ence who examined the rhetoric of early scientific programs and the prac-
10
tices of contemporary women scientists. For Evelyn Fox Keller, in Reflec-

tions on Science and Gender, the rejection of the feminine urged by Francis
Bacon suggested that science was in fact a masculine project; in her examina-
tion of the work of geneticist Barbara McClintock, Keller suggests that the
work of this woman scientist was shaped by a “feeling for the organism” that
was at odds with conventional (and therefore masculine) ways of doing
science.23
These challenges to the authority of science joined the critical analyses of
scientific practices undertaken by Latour and Woolgar, the close reading of
Darwin’s evolutionary theory within the context of nineteenth-century plot
structures by Gillian Beer, and the analysis of experiment as spectacle by
Shapin and Schaffer.24 Science studies have emerged as an interdisciplinary
examination of the discursive practices of the sciences, including both histor-
ical research and ongoing analyses of the daily work of contemporary scien-
tists, undertaken from a variety of political perspectives. The work of Donna
Haraway, for example, has evolved from rather conventional studies in the
history of anthropology to remarkably inventive texts used by cultural theo-
rists to study how bodies and their pleasures are constructed in a cybernetic
culture.25 Studies in the rhetoric of science consider such topics as persua-
sion, credibility or ethos, the discursive construction of presence, and scien-
tific uses of metaphor, of narrative structure, and of personification.26 This
work is often carried out in a critical dialogue with practicing scientists.27
Feminist studies of science, in particular, have been strengthened by the
participation of feminist scientists, beginning with the early interventions of
molecular biologist Evelyn Fox Keller and continuing through the work
of the apprentice scholars in the Biology and Gender Study Group.28 Out
of the Dead House brings to bear on this work the feminist studies of
nineteenth-century women’s reading and writing practices.29 Women’s medi-
cal writing can be contextualized in the genre of disciplinary medicine, and
it can also be read in relation to what women read and wrote; both perspec-
tives help us attend to what nineteenth-century women physicians tell us
about professional authority and textual power.
Feminist rhetoricians of science are only beginning to produce historical
studies of the rhetorical practices of early women scientists. Much of the
work on women scientists before the twentieth century has focused on accu-
mulating records of their bare existence rather than on analyzing the speci-
ficity of their scientific practice. It is not surprising, therefore, that the ideo-
logical characterization of science as a particularly male activity has not been
contested in either feminist or cultural studies of science, except by redefin-
ing science to include traditionally feminine activities such as gardening or
midwifery.
This book examines the women physicians of the last half of the nine-
11
teenth century as writers, especially as writers of science. If science is under-

stood as constructed by, among other things, certain practices of language,
then it is worthwhile to study how women performed those practices. I am en-
couraged in this study by the rich context within which these early physicians
undertook scientific work. They wrote and practiced in company with other
women; unlike such isolated eighteenth-century figures as the anatomist
Thiroux d’Arconville or the entomologist Maria Sibylla Merian, nineteenth-
century women physicians met with other women, wrote for them, and con-
sulted with them, simultaneously taking part, as they were able, in the work
of the male profession. Moreover, because their work as physicians was con-
tinuous with the traditionally feminine task of caring for the sick, women
physicians could draw upon a rich array of textualizations, including practices
of correspondence, popular advice, journalism, and fiction, especially the do-
mestic novel.
WOMEN PHYSICIANS, RHETORIC, AND

THE WRITING OF MEDICINE
My own approach to nineteenth-century women physicians is mediated by

my training as a literary scholar and my commitments as a rhetorician. Al-
though the texts written by nineteenth-century women do not tell us the
whole story of their professional lives, such texts are rich sources of informa-
tion about how they understood themselves, how they constructed the body,
how they made sense of their anomalous gender position. These writings
also contest the idea that scientific work is alien to women or that women
scientists write in a unitary, distinctly feminine voice. The idea of a distinctly
feminine scientific voice assumes that science is something produced almost
entirely by men, that women have made no contributions to scientific writ-
ing, and that science is a unitary and unchanging activity, substantially the
same in all fields and during all periods. I argue against all of these assump-
tions. Women doctors intervened in medical discourse at the very formation
of the modern scientific profession. They invented central tropes and strate-
gies for medical research and writing: the use of survey information, meth-
ods of taking patient histories, conventions for telling case histories. Women
physicians’ contributions changed as the profession developed, and individ-
ual women physicians produced quite distinct medical texts. This book traces
a specific history in its variations, locating women’s writing within the chang-
ing contours of medicine as a science and as a profession. It also accounts
for the pleasure women physicians took in the disciplinary activity of medi-
cine; avid for scientific knowledge, devoted to research and clinical practice,
they call into question any notion of scientific discourse as alien to women.
12
In order to study that work and that pleasure, I have used the terms of my
art: rhetoric has long concerned itself with what is probable, what is likely,
what is desired differently by different groups; it has been scorned by philos-
ophers since Socrates for attending to the discourses of women, children,
slaves, and other rabble.30 Rhetoric assumes that the speaking self is always
presented, always constructed, and that its truths are always provisional;
composition studies attend to noncanonical texts, pedagogical settings, stu-
dents’ approximations of achieved texts. My own desire in this work is to
question the self-characterization of scientific knowledge as masculine and
to recuperate a sense of women’s agency in scientific work, a sense of their
commitment to their profession and most especially their pleasure in its
practices. Overtaken by admiration for these women, I have chosen to repay
my filial debt to them by reading them, by seeing their texts as the work of
writers handling resistant materials, who made difficult choices and found in
the most forbidding situations the available means of persuasion.
In this book, discussions of individual women physicians and their strategies

of gender performance alternate with examinations of emerging professional
forms. Chapter 2, “Medical Conversations and Medical Histories,” recon-
structs, from hospital and clinic records and from books of medical advice,
how male and female physicians talked to their patients. Many women physi-
cians prided themselves on their ability to speak intimately with their pa-
tients; heart history was their term for the woman physician’s intervention
into her patient’s personal life. And women physicians do seem to have
talked differently to their patients, although the other treatments they of-
fered were completely conventional. But the “heart history” was contradic-
tory: it allowed patients to express themselves and to intervene in their own
treatment; it also offered the doctor a clear field for moral instruction of the
patient. Women physicians offered financial advice, supervised the patients’
reproductive life, and proselytized for their (quite unconventional) religious
beliefs; Freud would have called them wild psychoanalysts. All these contra-
dictions became more acute when the physician was an African American
woman, as demonstrated by the writing of Rebecca Lee Crumpler.
“Invisible Writing I: Ann Preston Invents an Institution,” chapter 3, is
an account of the writing of Ann Preston, who was thirty-eight when she
graduated with the first class from the Woman’s Medical College of Pennsyl-
vania (1850) and was associated with the college for the rest of her life, as
professor of physiology and later as dean. Preston wrote a great deal, but
much of her writing—school announcements, procedures, minutes of meet-
ings—was anonymous. When she did write under her own name, the occa-
sion was often ceremonial, a commencement or an inaugural lecture. Pres-
ton used the available materials, including the doctrine of a separate sphere
13
for women, to construct a rhetoric which supported women physicians. Her

gender performance was cross-dressed; Preston presents herself as an en-
tirely regular physician, distinguishable from males only by her interest in
the womanly and unglamourous issues of prevention and hygiene. That strat-
egy was replicable, functional in protecting the new Woman’s Medical Col-
lege, and costly, both personally and professionally.
“Learning to Write Medicine,” chapter 4, compares theses written by stu-
dents at the Woman’s Medical College with those written at the School of
Medicine of the University of Pennsylvania from 1850 to 1852, and examines
a group of theses written by African American students at the Woman’s Med-
ical College in the 1870s and 1880s. The theses fall into two groups: some
offer advice to a lay audience; others are addressed to other physicians. The-
ses written as advice—those in the register of health—model how the future
doctor would perform his duties as family counselor. Those written to other
physicians—a register of medicine—show that the student had attended
to faculty lectures and was able to reproduce them. While both men and
women students wrote in the register of health and the register of medicine,
theses from the Woman’s Medical College are distinct in two ways: They are
sometimes critical of the medical profession—a very exceptional perfor-
mance for a student suing for professional credentials, then or now. And
women’s theses are often marked by satire, a distinguishing rhetorical figure
for nineteenth-century women physicians. African American women physi-
cians faced additional rhetorical exigencies: they were deeply interested in
“race questions,” questions which their training did not help them answer,
and the issues of authority they negotiated were especially complex.
“Invisible Writing II: Hannah Longshore and the Border of Regularity,”
discusses a woman physician who was as resistant as Ann Preston was com-
pliant. Hannah Longshore, sister-in-law of a founder of the Woman’s Medi-
cal College, was associated throughout her life with such irregular medical
schools as homeopathy, the water cure, mesmerism, and spiritual healing.
Her relationship with the relentlessly regular Woman’s Medical College was
therefore quite problematic. This chapter analyzes a speech that Longshore
gave, in her old age, to the Woman’s Medical College Alumnae Association
and places Longshore within the context of her extremely eccentric and pro-
ductive family, a family who adopted strategies of travesty to express both
their admiration for and their distance from religious and scientific orthodoxy.
Chapter 6 analyzes the most scientifically engaged of the women physi-
cians I have studied, Mary Putnam Jacobi. With her hundred and fifty medi-
cal publications and energetic journalism, Mary Putnam Jacobi helped to
change the face of medical writing. In The Question of Rest for Women dur-
ing Menstruation, anonymous winner of Harvard’s Boylston Prize for Medi-
cal Writing, Putnam Jacobi was the first to use survey research in a medical
14
article. Her work on hysteria mounted a sustained critique of S. Weir Mitch-

ell’s rest cure; Putnam Jacobi, in fact, treated C. P. Gilman after the disas-
trous rest cure recounted in “The Yellow Wall-Paper.” 31 Completely unsenti-
mental, resolutely opposed to any separate sphere for women, Putnam
Jacobi had come to intellectual maturity in the world of French utopian so-
cialism, where science was seen as an efficacious way of transforming the
world. Putnam Jacobi’s performance of gender was often remarkably experi-
mental: by turns, she wrote anonymously, collaborated with other physicians,
insisted on her gender, denied its relevance, and accepted and rejected mem-
bership in the company of women physicians.
The final chapter of Out of the Dead House analyzes two medical spec-
tacles: the clinical lecture and dissection. Women physicians managed to
contain the potentially transgressive practice of dissection, but their entrance
into the more public ceremony of the clinical lecture could provoke riots.
These practices can be understood within the context of women’s popular
and vernacular interest in physiology, demonstrated in the formation of la-
dies’ physiological societies, the vogue for recreational dissection (usually of
small animals), and the popularity of public physiological lectures and exhib-
its. This chapter returns to the issue raised by the young Marie Zakrzewska,
delighted in the dead house: How can we understand the pleasures of medi-
cal knowledge as women physicians experienced them? How can we locate
those pleasures within the political and cultural context that supported them?
15
2
Medical Conversations and

Medical Histories
The medical practice that the first women physicians entered was one which
valued talk. The body’s story was not read from diagnostic images or test
results but composed from information provided by the patient and con-
firmed, if need be, in direct examination by the physician. Medicine was
therefore a heavily discursive practice, worked out patient by patient in a
series of conversations. Conversation initiated treatment, and conversations
marked its progress. The doctor would inquire about the patient’s symptoms,
the history of his or her illness, and daily habits and hygiene. The accompa-
nying physical examination might be limited to a cursory glance at the tongue
and survey of the pulse or include careful palpation of organs, auscultation
of the chest, and rudimentary laboratory work. Treatment almost always in-
cluded a prescription but possibly also minor surgery or (more and more
rarely after midcentury) bleeding or cupping, cautery, or blistering. The doc-
tor’s talk to the patient, however, was always a feature of treatment; hygienic
counsel, medical information, and calm encouragement were seen as essen-
tial to the cure. Since the patient was seen regularly until a cure was certified,
the conversation between doctor and patient would be protracted, often over
years. Given the uncertain efficacy of so many nineteenth-century treat-
ments and the growing rejection, especially in the middle of the century,
of such heroic measures as purging and bleeding in favor of therapies that
concentrated on strengthening the system, the medical interview was the
central discipline of therapy rather than ancillary to it.
In the later decades of the nineteenth century, when techniques of physi-
cal diagnosis developed, these conversations diminished in importance. Di-
agnostic devices such as x rays and laboratory tests more complex than basic
studies of blood and urine became available at the end of the century, and
microscopic investigations became common. At midcentury, it was a rare
physician who, after medical school, looked through a microscope. Also, al-
though pulse and respiration rates were counted, only the most scientifically
advanced physician used thermometers, and stethoscopes were optional.1
16
Medical Conversations and Medical Histories
Moreover, there was an extremely close correlation between medical con-

versations and the most common genre in nineteenth-century medical writ-
ing, the patient history. Even today, the patient history is so closely con-
nected with the initial doctor-patient conversation that patients who can
accurately narrate the course of their illnesses are called good historians.2
The case history is a venerable and durable medical genre; from Sigmund
Freud’s to Oliver Sachs’s, case histories have also been read by a lay audi-
ence. Contemporary medical histories offer concentrated, formulaic ac-
counts of patients’ experiences, sometimes produced by relatively inexperi-
enced physicians, intended to communicate with dispersed professionals and
to direct future investigation and treatment. In the nineteenth century, case
histories were a staple of medical education but quite diverse in form; stan-
dard conventions for collecting and reporting case histories developed, quite
unevenly, during the last half of the century. The nineteenth-century case
history might orient the attention of students, project a course of treatment,
or record a significant therapeutic advance; the form and structure of the
history varied with the interests and status of the writer.
Doctor-patient conversations and patient histories are and were important
sites for the linguistic performance of gender and so were especially prob-
lematic for women. Women patients faced contradictory constraints both
to speak frankly and to maintain a decent silence. Many illnesses we see as
having nothing to do with gender were, for nineteenth-century physicians
and patients, gendered experiences. Women sought treatment during preg-
nancy, childbirth, or menopause, but conditions such as eye infections and
general fatigue could be understood by both doctors and patients as repro-
ductive illnesses. For women patients, the medical interview was a conversa-
tion on potentially delicate subjects with a member of the opposite sex, even
when her symptoms were located far from her reproductive organs. When
the doctor was a woman, gender was even more salient to the conversation:
women doctors understood themselves as having conversations with their
patients that no male doctor could have had. As physicians and writers of
medical histories, women negotiated the cultural expectation that they be
empathic; they also developed institutional forms that supported distinct
medical conversations and encouraged the writing of distinct texts. At these
sites, women’s discursive performance of their gender inflected the nondis-
cursive medical treatment they were likely to provide or receive; an ideology
of unorthodox treatment could be combined with the most conservative reg-
ular therapy. (But of course, talk was also part of the therapy, so that uncon-
ventional talk was also unconventional therapy.)
Contemporary studies of medical discourse can inform our investigation
of these historical practices. Such studies demonstrate that, while men and
women do not use different languages in medical settings, they do use lan-
17
guage differently. Very broadly, sociolinguists have identified no variation in

lexicon or syntax that reliably differentiates women’s speech from men’s. Al-
though some writers have suggested that women use a distinct vocabulary
or are more likely to produce certain sentence forms, no empirical study has
supported such claims. In speech or in writing, gender difference typically
emerges as one of a number of variables, and its significance changes radi-
cally depending on class, relations among language communities, and family
structures.3 But sociolinguists have repeatedly identified gender differences
in the large rhetorical structures of conversation. In the sites of American
culture that have been studied, men talk more than women, and the two
genders follow different conversational strategies. They have different ex-
pectations of one another and treat one another differently, although those
differences are themselves inflected by race, class, and age. These differ-
ences were probably more marked in the mid-nineteenth century, when
men’s and women’s economic and social spheres were more distinct, al-
though we should not assume any simple story of progress.
The medical interview was central to clinical care and unavoidably gen-
dered; women participated in the interview as both patients and physicians.
The histories based on such interviews form an important body of medical
texts. The rich body of contemporary studies of doctor-patient interviews
poses questions about nineteenth-century conversations, demonstrating that
the work of the medical interview affects patients’ understandings of the
diagnosis, their emotional attitude toward treatment, and their compliance
with it. The interview also affects the doctor’s orientation toward the patient
and the course of his or her treatment.4 To study how women participated
in, formed, and were themselves constructed by the medical discourse of the
nineteenth century, then, I begin by listening to the talk of the consulting
room.
IMAGINED CONVERSATIONS I: THE DOCTOR’S HOPE
Any analysis of nineteenth-century medical conversations must rely on indi-

rect evidence; nineteenth-century medical records, including hospital notes
and clinic books, rarely quote patients directly but often suggest something
of what passed between doctor and patient. Other genres of physicians’ writ-
ing, including the voluminous popular medical literature, supplement these
accounts. In popular medical literature, male and female doctors told exem-
plary stories, often organized as dialogues with patients. In examining these
records, it is not at all my intention to evaluate the medical care that these
physicians provided—an evaluation that would be ill-informed and imperti-
nent. After all, these patients and their physicians, even if they had received
18
and given the best conceivable care, would certainly be dead today. Their
ways of speaking and hearing have perhaps survived them, if only in the
medical imaginary. In the records of these conversations, we can discern how
doctors and patients, women and men, constructed bodies that were gen-
dered, articulated into the family and the economy, and treatable in scientific
ways, and we can appreciate both the productive, generative possibilities of
such constructions and their potential for oppression and control.
Two assumptions salient to contemporary doctor-patient interactions
simply did not operate in nineteenth-century medicine: the constraint of uni-
versalism, under which all patients suffering from the same ailment should
receive the same treatment, and that of functional specificity, which de-
mands that the doctor’s intervention be limited to medical matters.5 While
neither of these principles has ever been more than a goal of medical treat-
ment, each does regulate the discourse of medicine; the patient’s social class
or moral state cannot be explicitly given as a reason for a course of treat-
ment. To a mid-nineteenth-century physician, both assumptions would have
seemed wrongheaded. Hospitals routinely offered or denied treatment on
the basis of the patients’ perceived moral state;6 doctors prided themselves
on their ability to transform patients’ personal lives and beliefs. Nor did phy-
sicians accept universalism as an axiom of treatment: the Woman’s Hospital
associated with the Woman’s Medical College of Pennsylvania, like other
Philadelphia hospitals, refused to manage the births of unmarried mothers.7
Women physicians like Harriot Kezia Hunt and Ruth Gleason saw them-
selves as family counselors and often asserted that only to women doctors
would patients confide “heart histories” and that such confidences would
transform both their health and the state of their souls.
Then as now, however, conversations between doctors and patients began
not with ethical questions but with issues of complaint and diagnosis. Today,
the medical interview is organized as a series of steps, taken in an obligatory
order: The patient’s chief complaint is elicited and placed within the context
of the present illness. The physician takes the patient’s past history, family
history, and some social history—sometimes called a patient profile—and
then reviews, in greater or less detail, the physiological systems. The inter-
view concludes with a physical exam, although sometimes questioning over-
laps with the direct examination, and sometimes the two segments of the
initial encounter are separated. The direct examination is followed by other
tests. All these investigations are written up in the patient history. Theoreti-
cally, the interview ends with the doctor offering a diagnosis and treatment
plan. Because these critical issues are negotiated over time and are often
unsuccessfully communicated, the diagnosis may survive more clearly as a
notation in the patient history than as a shared understanding between doc-
tor and patient.8 Medical anthropologist Howard Waitzkin, while declaring
19
that the origin of the structure of the medical interview is “currently a mys-
tery,” 9 suggests that it was formulated in the late nineteenth century and
associates it with German scientific medicine.10
In the mid-nineteenth century, neither the structure of the medical inter-
view nor the form of the history had been stabilized. Since the doctor-patient
interview was an extremely complex interaction, it is not surprising that pa-
tients had to be taught to carry out their part in it. And mid-nineteenth-
century literature for patients is so full of guidance that talking to the doctor
must not have been easy, especially for women. Popular medical texts of-
fered stories of young girls who suffered from ignorance of the onset of men-
struation, of middle-aged women who called in a physician for the birth of a
child nine months after their periods stopped, never having heard of meno-
pause. One response of physicians, newly organized in the fledgling Ameri-
can Medical Association, was to compel speech, often with threats of even
more shameful consequences. Thus, the Code of Medical Ethics adopted by
the National Medical Convention in Philadelphia (1847), warns patients to
“faithfully and unreservedly communicate to their physicians the supposed
cause of their disease” and never to “be afraid of thus making his physician
his friend and adviser.” Women were particularly enjoined against allowing
“feelings of shame or delicacy to prevent their disclosing the seat, symptoms
and causes of complaints peculiar to them.” 11
But such candor could have its price: even in the twentieth century, pa-
tients’ truthful responses to questions can expose them to a “humiliation
ritual,” in which the physician evaluates the quality of the patient’s compli-
ance.12 Further, it was not at all clear just how forthcoming the nineteenth-
century patient was expected to be. Immediately after encouraging the pa-
tient to make the physician his friend, the Code of Ethics cautions him
against wearying his physician “with a tedious detail of events or matters not
appertaining to his disease.” The patient should answer the doctor’s ques-
tions, and not “obtrude the details of his business nor the history of his family
concerns.” 13 How was a patient to know whether her personal and family
concerns were “tedious details” or the secret causes of her disease, which
she was bound to reveal? The physician’s “interrogatory” would substitute
for the patient’s “minute account,” so that the direction, topic, and pace of
the medical interview were all in the physician’s hands.
Given the strong tendency of mid-nineteenth-century medicine to diag-
nose women’s illnesses as reproductive and the strong sanctions against
speaking in mixed company about sexual matters, women might well have
withdrawn from the contradictory injunctions of the medical interview and
maintained that reserve which was always correct. Reformers who sponsored
women’s medical education in the nineteenth century hoped that women
physicians would preserve both women’s modesty and their health. Samuel
20
Gregory founded the New England Female Medical College in 1848 to pro-
tect women patients from predatory and corrupting male doctors; Gregory’s
intemperate remarks made few friends for the new college among regular
physicians. And the founders of the Woman’s Medical College of Pennsylva-
nia often spoke of women’s difficulties describing their symptoms to doctors;
the first announcement lamented:
How often does it occur, that the intolerable anguish attendant on disease,
has been insufficient to induce the sufferer to make known the nature of her
malady; either from too strict a sense of delicacy, or dread of exposure? In the
education of intelligent and respectable females for the exercise of professional
duty, all such difficulties will have been obviated, and she may, in hope of relief,
communicate freely to one of her own sex, those secrets and sorrows, which
nothing on earth could induce her, under other circumstances, to divulge. This
is not an exaggerated picture in human life; limited indeed must be the observa-
tions of any one who is not familiar with some similar instance.14
In one of his commencement addresses, Woman’s Medical College Dean

Edwin Fussell claimed that the college had been founded to preserve
modesty:
Sensitive plants shrink from the common touch! Many sensitive women were
seen suffering and dying, rather than shock what they felt to be the sacredness
of their womanhood. . . . It is needless here to enquire, whether it is a healthy
sensitiveness, or a morbid one, which causes a woman to endure pain, and die
of disease, rather than receive aid and relief from a source which would shock
her womanly feelings. . . . The existence of the evil being seen, and the necessity
for its removal being strong; this College was instituted to provide a remedy; for
this object it is in operation now.15
Although many reformers thought that women physicians should not treat
male patients, common wisdom held that women caregivers were best at
talking with all patients, even young men. In Louisa May Alcott’s Hospital
Sketches, based on her experience as a Civil War nurse, she recounts a con-
versation with a surgeon who casually commissioned her to tell a soldier of
his impending death, since “women have a way of doing such things comfort-
ably.” 16 Although such a “comfortable” talk would never be recorded in hos-
pital records, both male and female physicians left extended accounts of
their talks with patients. Writing in the great age of the realistic novel, physi-
cians who trained students or instructed the general public transposed the
conventions of fictional conversation to compose instructive cases for the
education of students or the edification of the general public. These stories
are not empirically accurate records of doctor-patient conversation, but they
do represent what physicians thought they were doing when they were talk-
ing well with patients.
21
We can begin with an example from a prominent male physician at mid-

century. Charles Meigs, a gynecologist teaching at the University of Penn-
sylvania School of Medicine, presented patient interviews in his lectures to
medical students; some were frankly fictional and idealized; others were
presented as records of real cases. Whatever the medical issue, the central
question in these conversations was often the physician’s authority. Only that
authority could enforce the vaginal examination, which Meigs called (appro-
priately enough, in those prespeculum days) “examination by Touch.” In the
published collection of his lectures, he recounts an interview with a patient
who had been sick six and a half years and whom he diagnosed as suffering
from a uterine polyp and proposed to examine and treat. The woman replied:
“But I cannot let you do it.”

“You ought to have it done; at least, you ought to have it examined, for, though
I am very sure of finding the polypus, I have never yet had any sensible sign of
it. I only judge it to be there.”
“I cannot.”
“Very well, madam. You have bled six years and a half; you are greatly re-
duced; your blood is thin as water, and if you go on much longer, there is fear
you will have a dropsy, and then lose your life. Would that be wise, or foolish?”
“I can’t help it; I cannot think of being examined.”
“Very well, it is your affair, not mine. I have no other advice for the present
than that you should carefully revolve the prospect before you, and, if you should
change your mind, you can let me know if you should desire to see me.” 17
The patient’s voice in this interview may owe as much to the iterated “ce
n’est pas ma faute” of Les Liaisons dangereuses as to any words spoken to
Meigs; he threatened dire consequences to the patient but refused to argue
with her.18 He did not support his claim to superior knowledge; he gave no
evidence of the polyp but stated that he could “judge it to be there.” There
was no shielding of the sensitive plant; Meigs, in fact, professed indifference
as to whether his advice was followed or not. Medical knowledge was pre-
sented as a source of certainty that need not explain or defend itself.
Not all Meigs’s conversations with patients turn on such bare assertions
of authority. In his treatment of a fictional patient named Helen Blanque,
also included in his published lectures, Meigs portrays himself as a man of
science and culture, playfully and paternally educating the patient.19 Meigs
found Helen
reposing in a luxurious fauteuil of the richest crewel work. She was arrayed in a
beautiful negligee, and her slippered feet rested on a low ottoman. The apart-
ment was richly furnished with mirrors, and chandeliers, and candelabras, and
carved sofas, with chairs of every form and hue.20
22
No more Laclos; Meigs gives us a Balzacian interior, littered with signs of

cultivated gentility. Meigs greeted Helen:
“Good morning, my dear Helen; I hope you are not very sick; and indeed I
must think you are not, if I may judge by your fair face and bright eyes. What
can you possibly want with a doctor? Don’t you know it is a very dangerous thing
to meddle with people who go about the world with their pockets full of lancets,
blue pills, and iodine?” 21
Miss Blanque complained of weakness; she had been sick two and a half
years, fainted when she shopped, couldn’t dance or go to church, and found
that life was no longer worth living.
“Tilly vally, child! there is little the matter with you. You are not half as ill as you
think for, and that I shall soon show you.” 22
After this bracing remark, Meigs asked after his patient’s age, prior health,
and age at the onset of menstruation. He determined that her periods had
been regular and inquired about their duration and intensity; we are, for the
first time in this conversation, in the territory of the standard medical history.
Blanque claimed that her periods had diminished since her illness; she la-
mented, “It’s leaving me. I’m growing old.” 23 Meigs replied that she was a
veritable flower-bud, asked about her sleep, digestion, bowel movements,
and exercise, auscultated her chest, estimated the volume of her inhalations,
counted her breaths and her pulse, inspected her color, and inquired about
her weight—all diagnostic procedures that bespoke scientific precision. (In
contemporary records from the Jefferson Hospital clinics, it is very rare to
read such counts of vital signs.)
Meigs promised to cure Helen, so that she would have “two cheeks like
the sunny side of an apple; and those pale lips shall pout like twin cherries.”
He asked if she could “move about”; Blanque protested that she could barely
stir, but Meigs had her climb to the second story, took her pulse, and ex-
plained her accelerated heartbeat, inquiring, “Do you understand that, or is
it all Greek and Hebrew to you?” Blanque did not follow Dr. Meigs: “Indeed,
indeed, I hav’n’t the least notion of it except that it tires me to death to go
up and makes my heart palpitate like the fluttering of a pigeon. It’s very
strange.” 24
Finally, Meigs offered to instruct Helen Blanque on the cause of her dis-
order. Blanque transformed herself from a fluttering pigeon to a fearless
daughter of the enlightenment: “If you address my common sense, you will
command my most implicit faith and compliance. Women, who seem to be
a sort of human Parias—who have lost caste—are always flattered and
soothed by being treated as if they were really reasoning beings; for when so
treated they seem to have regained their caste.” 25 Meigs lectured Blanque
23
on the composition and formation of the blood; her own, he said, was too
thin and watery. He prescribed exercise—six miles of walking a day—but
this therapy was a small part of Meigs’s performance. He read from a
fifteenth-century copy of Seneca left conveniently lying about, recounted
stories of prize fighters in training, told the story of Galatea, and quoted from
Macbeth. This talk, Blanque declared, already half cured her, and, relieved
that she had not been forced to show her tongue, bled, blistered, or dosed,
she promised that her father would gladly pay a handsome fee.
In later lectures, Meigs countered critics who found this conversation “in-
delicate” by reminding them that it was fictional, and he explained that, while
Blanque presented symptoms usually associated with a prolapsed uterus, he
delayed an internal examination because he “held conscientiously to abstain
from any unnecessary inquiries or modes of inquiry.” 26 In her case, since
a systemic treatment had been succeeded, there was no need to proceed.
(Blanque’s reality wavers in these accounts; the fictional patient’s cure vindi-
cates the fictional treatment.) Meigs had offered his students an almost com-
ically malleable patient with whom he enacted a common class membership,
just as his conversation with the patient suffering from a uterine polyp en-
acted his assumption of class superiority. For Blanque, Meigs was an all-
purpose generic professional, taking by turns the role of scientific observer,
patient but exacting teacher, and kindly clergyman. The sources of the doc-
tor’s authority include his status as an upper-class gentleman, his ability to
read and name all the paraphernalia of gentility with which the patient is
surrounded, his easy movement from the medical interview to compli-
mentary banter, his knowledge of “the world” beyond the boudoir (as in the
boxing example), his ability to interpret the physical signs before him and
to elicit such signs experimentally, and finally, his knowledge of physiology.
Meigs’s professional authority is a gentleman’s learning, displayed lightly, of-
fered in polite conversation. The doctor compliments his Helen, but there
is no doubt that he is in charge; they joke, she complains, but in the end she
submits. Helen Blanque, obligingly running up and down stairs, volunteer-
ing the details of her menstruation, is as compliant as Petruchio could have
ever wished Katherina. After a few ineffectual protests, she cedes control of
the discussion to the physician. Having summoned him, having insisted on
her fragility, she listens to him with delighted attention and resolves to order
her life according his advice. Meigs’s authority also rests on what he refrains
from doing: especially, he does not do a vaginal examination or even look at
Miss Blanque’s tongue; he does not quarrel with her avocations or her life
choices but only asks that she take exercise.
Blanque’s “cure” rests entirely on her coming to believe that she is not
sick, that she is entirely capable of walking six miles a day. Ronald Chenail’s
24
contemporary analysis of doctor-patient conversations describes the work of

“frame construction”: both parties must agree whether the patient is to be
understood as sick or well, and that understanding is as consequential for
the patient as many of the physical signs of health or illness.27 Meigs is at
some pains, in this fictional interview, to contain Blanque in what Chenail
would call the “gallery of health,” to interpret her symptoms as the effects
of inactivity and youth rather than as signs of a physical ailment. Meigs’s
repeated descriptions of the restored, radiant Blanque are therefore thera-
peutic interventions; the physician imagines the patient as healthy so that
she can leave off being sick. The physical examination would shockingly vio-
late the frame of health, since only a serious illness would justify such an
intervention. Meigs’s postponement of the examination in favor of general
systemic treatment conserved Blanque’s understanding of herself as healthy.
We might expect, given the connections between euphemism and obscen-
ity, that wherever such performances of modesty and delicacy are enacted,
a different site permits different (and plainer) speech. And doctors, as men
of the world, spoke freely to each other about the body, particularly about
women’s bodies. That speech may have served as a rite of passage for male
medical students; it was certainly one of the reasons why the medical coedu-
cation of men and women seemed impossible to physicians. Sociolinguists
call such ways of speaking “registers”; these repertoires of speech perfor-
mance are marked by their own systems of word choice, syntax, oral genres,
and rhetorical forms. And the records of nineteenth-century medical schools
offer many examples of this worldly register of medical discourse. One stu-
dent notebook, kept by Dr. W. Fulton in 1866, records the lectures on gyne-
cology given by Professor Wallace at Jefferson Hospital.28 The notes, kept
in a meticulous hand, earnestly record Wallace’s witticisms; a later reader
marked the more racy passages with penciled exclamation points. We find,
for example, Professor Wallace’s claim that “that little cervix will throw more
practice into your hands, than will all the rest of the body put together” and
his account of one of his ancestors “who now sleeps beneath the shadow of
St. Stephen’s Church died aet. 104, and had but one child, and that, when
she was fifty-three. ‘Had it not been for her great ovarian power,’ said he, ‘I
would not stand before you to-night to tell the tale.’”29 Wallace spoke of
pessaries, of gonorrhea, of married women infected with syphilis by their
husbands, of cleanliness and cold water syringes; everything normally so-
cially unspeakable became, in the lecture hall, a fit topic of conversation. Nor
did such talk end in medical school. The Philadelphia Medical and Surgical
Reporter for May 31, 1884, includes an article titled “Women Are Dirty
Creatures, Anyhow!” reporting on a discussion of gonorrhea at the Philadel-
phia County Medical Society. The editor comments:
25
At first we were staggered by the ungallantry of the remark, and wondered at it.
A few words more, and we not only realized the full force and meaning of the
remark, but felt that it was so eminently true that a few words of advice on the
subject would be most opportune. The remark was meant for the vagina, and
our friend [the physician giving the report] went on to ask how many women
ever syringe out the vagina, unless ordered to do so by a physician, and yet how
few women are there who have not some kind of a vaginal or uterine discharge?
The old university resurrectionist, Nash, used to say (more forcibly than ele-
gantly) that every man with an elongated prepuce had a cheese-factory at the
head of his penis; by which he meant to convey the idea of the accumulation of
smegma which occurred in those so formed, unless they were very particular
about washing the glans. So our friend referred to the accumulation and decom-
position of the various discharges in the vagina, which must necessarily result in
making this cavity a very foul place indeed.30
Such conversations are evidence of intense horror and fear of women’s bod-
ies. They also permit pleasure in transgressive speech; the physician who
knows the body is allowed to speak about it, to name its parts and describe
its discharges; he may thereby offend against “elegance” or “gallantry” but
not against decency. And medical experiment or scientific curiosity could be
a transparent cover for sexual curiosity. An 1883 letter by S. E. McCully in
the American Journal of Obstetrics reports his questioning of women pa-
tients about their experience in masturbation. McCully described his “exper-
iments” to settle the perennial question of whether women ejaculate fluid at
orgasm: the vagina was washed, a rubber cap placed over the cervix, and
“an orgasm is induced.” McCully defended his experimental technique: “My
experiments have been conducted with great care, taking into consideration
all secreting glands in the neighborhood. . . . Several times no ring or sac was
used, and my index finger was placed against the most dependent portions
of the cervix on these occasions, so as to be able to carefully detect every
motion of the organ, while my thumb was in contact with the clitoris.” 31
It was particularly difficult, given these conventions (and subversions and
abuses) of free speech, for male physicians to imagine themselves consulting
with women physicians. The embarrassment of joint consultation was one of
the central reasons for the Philadelphia County Medical Society’s resolution
against the Woman’s Medical College of Pennsylvania. Consultation with a
woman physician was contamination; a doctor who consented to such talk
should be expelled from the society. When Joseph Lister was asked by Peter
Bell, secretary of the Royal Infirmary of Edinburgh, for his views on medical
coeducation, consultation was one of his chief reasons for refusing to enter-
tain the possibility: “Being thrown into intimate association with [members
of the opposite sex] for consultation & aid in professional emergencies,
would, I fear, lead in the long run to great inconvenience & scandal.” 32
26
When Elizabeth Blackwell began practice in New York, she asked a “kind-
hearted physician of high standing” to advise her in managing a severe case
of pneumonia. She accompanied him into the parlor after he had examined the
patient. Blackwell recounts her surprise at the other physician’s confusion:
I listened with surprise and much perplexity, as it was a clear case of pneumonia
and of no unusual degree of danger, until at last I discovered that his perplexity
related to me, not to the patient, and to the propriety of consulting with a lady
physician! I was both amused and relieved. I at once assured my old acquain-
tance that it need not be considered in the light of an ordinary consultation, if
he were uneasy about it, but as a friendly talk.33
All of Blackwell’s skill in reframing was called for here; the physician who
first learned the register of consultation as the performance of free (and pos-
sibly indelicate) speech cannot transpose that talk into a register acceptable
for conversation with a lady. Blackwell suggested an alternate register, that
of the friendly talk, in which “women have a way” of putting men at ease and
making the conversation go smoothly. Her invitation was accepted, and all
went well; they consulted without having had a consultation.
In Meigs’s examination of the fictional Helen Blanque, the physician at-
tends to fauteuils, embroideries, and rare editions, to the apparatus of femi-
nine daintiness that is metonymic to sexual delicacy; at other times, in other
settings, he turned the register of polite conversation inside out, and pre-
cisely those organs that had been unnamed became fascinating. At each mo-
ment, the physician and his interlocutors know of the existence of an alternate
register; we can read in Helen Blanque’s thanks to Meigs for not asking her to
“poke out her tongue” an acknowledgment that the interview might have gone
differently, and in the editors’ admission of ungallantry, a recognition that their
free speech was a professional privilege. Consulting with a woman physician
made explicit what had been tacit; such extraordinary talk would have re-
quired the male physician to negotiate disparate registers consciously.
Meigs’s discussions, Wallace’s lecture notes, and the difficulties of consul-
tation suggest that male physicians employed an armamentarium of devices
for producing compliance: the patient could be left to herself or cosseted;
spoken about with coarse bluntness, or pruriently, or with baffled sympathy;
instructed in physiology or left in ignorance of her true diagnosis. This vari-
ety of tactics speaks of a situation in which women did not easily cooperate
in medical investigations. Wallace had to counsel his students to “question
and crossquestion your patient every time,” 34 and the modeling of those
questions was an important element of clinical education.
But these tactics were not always successful. However much Meigs might
have imagined a “blank” patient, ready to be inscribed with his own version
of popular physiology, midcentury women did not simply comply with their
27
male physicians: they read medicine; they had opinions about their ailments
and their treatment; they had something to say, but if all else failed, they
could take recourse in the strictures of propriety and fall silent.35 While med-
ical ideology stipulated the doctor’s control of the interview and the primacy
of his medical knowledge, the gaps in that ideology and the evidence of hos-
pital records suggest that the doctor’s control was uncertain, that the salience
of his knowledge had to be continually negotiated, and that the patient could
strategically offer her own knowledge of her body. The conversations com-
posed by Meigs tell us as much about the desires and hopes of male physi-
cians as about how their female patients acted.
A different sense of nineteenth-century doctor-patient conversation can
be reconstructed from medical histories written in hospital settings. Meigs’s
account offers images of medical authority relentlessly brandished and never
effectively resisted, of treatment based on medical knowledge, mediated by
the physician’s personal power. The medical histories from hospitals offer a
sense of the constraint of cross-gender conversation and of the avidity with
which doctors took up the freedom of all-male professional conversation.
These accounts of medical conversations speak powerfully, therefore, about
what male doctors hoped for and feared in their conversations with women
patients. The realities of actual conversations and the hopes and fears of
women doctors were both somewhat different.
IMAGINED CONVERSATIONS II: THE HEART HISTORY
Everyone agreed that it was easy to talk to a woman physician. No writer

imagined her “questioning and cross-questioning” her patients, as Wallace
counseled her male counterparts, and even the strongest opponents of wom-
en’s medical education conceded that women patients would confide in her.
It is not surprising that early women physicians claimed a distinct profes-
sional practice founded on the unconstrained confidence between patient
and physician. On this ground, women physicians developed and deployed
distinct forms of professional authority. Patients were described as telling a
“heart history,” of which the woman physician was an understanding, but
unswervingly moral, auditor. Her response to the heart history established
the exigency of her authority, intimate and inexorable.
Attention to the heart history cohered with women physicians’ common
(but not universal) preference for conservative therapies. Often, graduates
of the Woman’s Medical College invoked the vis medicatrix naturae, and
they advocated systemic treatment rather than harsh remedies; medication,
rather than surgery. But such conservatism was very widespread among
nineteenth-century physicians.36 Whether this quietism is understood as an
28
effect of clinical empiricism or as a response to the competition of sectarians

with their benign baths and homeopathic doses, women physicians who
opted for conservative treatment were squarely in the mainstream of their
contemporary practice.37 In the accounts of their own medical practice writ-
ten by such physicians as Harriot K. Hunt and Rachel Gleason, however,
conservative treatment becomes a kind of talking cure, so that the telling of
the heart history is not an adjunct to care but virtually its central therapy.38
And the heart history could also support quite invasive and heroic measures.
What we might call the canonic form of the heart history can be found in
the writing of Harriot Kezia Hunt. In histories of women and medicine,
Hunt is usually described as the first American woman to make her living as
a physician, although there were surely herbalists, Thompsonians, and bo-
tanical practitioners before her. Her Glances and Glimpses gives a detailed
account of her decades of medical practice, from her training by Anna Mott
in 1834 in the use of vegetable remedies through her years of medical prac-
tice in Boston.39 Although she applied for admission to the Harvard Medical
School several times, she was repeatedly turned down, and her only medical
degree was an honorary one granted by the Woman’s Medical College of
Pennsylvania.40 Conversation was central to Hunt’s therapy, and Glances and
Glimpses reports many conversations between Hunt and her patients. In the
whole book, Hunt never offered any treatment more intrusive than a “cham-
poo”or a tonic, but she conducted a number of remarkable conversations: a
mother was induced to allow her sickly daughter to go to dancing school; a
nervous woman was sent out to the fields to sit with her cow; a widow was
counseled to look to her own financial affairs rather than trusting the execu-
tor of her husband’s will. Hunt was proud of hearing so many “heart histories
of women,” which “were revealed to us [only] as women. . . . From male
physicians the causes of the diseases of women, as well as the extent of those
diseases, are often concealed!” 41 She felt that she should speak freely to her
patients: “I never feared to use the utmost boldness of speech; for I certainly
felt that volcanic eruptions of condemnation were safe remedial agents,
when love had melted the lava.” 42 One case, that of a melancholy middle-
aged woman, illustrates the complexity of Hunt’s practice:
She began to tell me of the inroads disease had made upon her, of sleepless
nights, loss of appetite, etc. etc., but I found my thoughts wandering from the
body. I wished to search the spirit,—approached gently and said, “tell me some-
thing of your mother”; here was a key which unlocked the heart. “I lost my
mother in early childhood and never was a child again—no one understood me,
no one cheered me, no one shed around me the halo of love.” Away in the dis-
tance of thirty-five years did I trace the causes that had sapped health and de-
stroyed happiness—a gushing, noble nature had been restrained and crushed;
it yearned for utterance, but no kindred spirit echoed back its thought or shared
29
its emotions, icy conventionalities choked thoughts struggling for expression.

The secret was revealed, she had been educated in that proper circle, where
soul is termed sentiment; suspicion, censure, and ridicule had driven her
within herself.43
The patient’s loneliness had not been relieved by religion or marriage; she
had been estranged from her only child, a daughter who was distant from
her until the child’s final illness:
During her [the daughter’s] last illness her interior life opened—her mother
learned too late that there was a wealth of soul in that artificial being which she
had never dreamed of. The father went through the usual forms of grief, the
funeral was grand, the monument was artistically beautiful. The mother was left
in utter desolation—health failed. Reader, could you have seen the light that
passed over the deep shadows of her face, as I spoke of spiritual communings
not as a theory, but as a fact, not as an ideal, but as real. Her nature was hopeful,
buoyant, but it had been crushed; when the voice of faith touched her ear, it
penetrated her soul; hope sprung to life, instant resurrection came. The time
between her mother’s removal and the birth of her child seemed annihilated,
her early love returned, the maternal kiss she received was mingled with the one
she gave, and mother and child were guests within; then came a deep sense of
responsibility, of the importance of living true to her new found life; duty and
usefulness were adopted as her watchwords.44
More than one of Hunt’s interviews turns on a wild psychoanalytic ques-
tion about the patient’s mother, her probing inflection of the conventional
query about the patient’s family history. Hunt’s therapy was based on the
continuity between past and present, between what is suffered and what is
done, so that the daughter and the mother, for her, inhabited the same body.
She offered her patient the chance—perhaps her first chance—to talk about
loss and grief.
That is not all that Hunt offered; when she suggested to the patient the
possibility of “spiritual communings, . . . not as an ideal, but as real,” she
proselytized for spiritualism, an immensely popular practice in reform and
feminist circles.45 Hunt was herself a Swedenborgian and promoted the be-
lief that direct communication with the dead was possible. This intervention
was perhaps unorthodox but was not improper by nineteenth-century stan-
dards; women physicians were expected to edify their patients. The 1852
annual announcement of the Woman’s Medical College asked, “Who so
proper as woman, in whose heart religion so readily finds a home, to point
the sick or dying sinner to repentance and a Savior here and unending con-
solations hereafter?” 46 Since there was no canon of moral neutrality for a
nineteenth-century physician, Hunt was quite correct in offering her beliefs
at retail to her patients.
30
Not all doctors relied so heavily on therapeutic conversation; not all heart
histories were so readily or so fully offered; not all therapies were so mild. At
the twelfth annual meeting of the Woman’s Medical College of Pennsylvania
Alumnae Association (1887), Elizabeth Keller presented the history of a pa-
tient suffering from nervous illness who cooperated wholeheartedly with her
heroic treatment.47 Keller’s patient had entered treatment nine years ago, at
twenty-one, for painful menstruation. After several years, “she said that . . .
there was another source of suffering that she could not explain, that was
separate and distinct from the menstrual pain.” The patient felt sudden pain
walking, using a piano pedal, or on the steam cars, leaving her exhausted.
She feared that she would go insane; she could not bear her music, or any
strong emotion. In the fifth year of treatment, Keller reports, “I inquired
further in regard to this feeling which she called intense suffering, and asked
her the question plainly, whether she had ever indulged in the habit of self-
abuse; to which she replied, ‘No.’ She answered with a great deal of earnest-
ness, and I had no reason to believe that she was telling me an untruth.” 48
The patient became convinced that her father was a stranger “cohabiting
with [her] mother,” and she was eventually hospitalized for mania: “She was
under treatment, but was believed to be a hopelessly insane woman. Every-
body had a counterpart,—that was her principal trouble—everybody was
false, nothing true about her.” 49
Her family could not afford hospital fees and took her home, where she
grew worse, thinking that “every woman was a man, and every man a devil.” 50
Keller diagnosed the patient as suffering from “reflex insanity,” caused by a
disorder of the ovaries, and proposed surgical treatment—not an unusual
treatment for mania but not the systemic approach associated with women
physicians either.51 Like the many patients studied by Nancy Theriot, pa-
tients who demanded gynecological surgery, Keller’s patient “wanted it,
begged for it,” 52 and administered the ether to herself. Keller removed both
ovaries, ligaments, and Fallopian tubes. The patient’s first words on awaken-
ing were, “If I have these delusions, do not try to persuade me. I find I can
reason now myself.” The ovaries and tubes were found to be abnormal; in
the discussion after her paper, Keller declared that the patient was a virgin
but suffering from a “very sensitive, morbid condition, set up by the degener-
ation of the ovaries and tubes. I believe that girl’s sufferings were due to
orgasm, and it was that, which led to her insanity.” 53 Orgasm is sadly ambigu-
ous; for nineteenth-century physicians, it did refer to sexual release but also
to any state of turgor or excitement; the patient’s “tortuous and congested”
Fallopian tubes could have been at issue.54 Keller’s “no reason to believe she
was telling me an untruth,” however, now reads as a doubled negative hedge:
the patient had lost her sanity (temporarily) and her ovaries (permanently)
31
to masturbation that she could not speak about, even though she spoke viv-
idly and directly about her experience of the world and her body.
This case is striking in the directness and precision with which Keller re-
cords her dialogue with the patient. In her retrospective account of nine
years of treatment, the patient’s report of another source of suffering and
her avowal that she could reason now herself are quite distinct. Keller valued
the voice of this patient in all its unreliable singularity and had learned, per-
haps from novel reading, to record that voice in terms we recognize, even as
she interpreted the patient’s doubled world as a symptom of her inflamed
tubes, even as she set aside the patient’s disavowal of masturbation, even as
she claimed no therapeutic role for either the patient’s history or her re-
sponse. Of all the patients described by either male or female doctors in
these case histories, Keller’s is the most realized, the most complex in her
relation to the physician. She trusts the physician and is avid for treatment,
but she may not have told the truth. She gives a vivid account of her illness
but will not give up the story of its cause. Alone among these patients, she
refuses the doctor’s discourse: “. . . do not try to persuade me. I find I can
reason now myself.”
The telling of the heart history could also offer a woman physician oppor-
tunity to intervene in her patient’s reproductive life. In the nineteenth cen-
tury, this intervention would have been seen not as irregular but as respon-
sive to central concerns of women physicians. All women physicians knew of
Madame Rastell, the New York abortionist whose reputation as a “female
physician” made their own work morally suspect. It had been Madame Ras-
tell’s profanation of motherhood, in fact, that finally determined Elizabeth
Blackwell to overcome her repugnance for the body and become a physi-
cian.55 Early graduates of the Woman’s Medical College, writing on such
topics as medical jurisprudence and criminal abortion, specified ways of
determining whether abortions had been induced and ways of resisting pa-
tients’ pleas for help in obtaining one.56 Rachel Gleason, a water cure physi-
cian who, with her husband, ran a popular sanitorium in New York State,
told women who came to her for abortions that a woman who married was
obliged to accept children as they came, and she disputed their belief in
the legitimacy of abortion before “quickening,” when the fetus could be felt
moving. She offered “no advice” to women who wanted to avoid having chil-
dren for reasons of health, commending them only “to a husband’s consider-
ation, and the counsel of a conscientious family physician,” chillingly urging
them to be “true mothers,” whether “among the weary ones of earth, or those
so worn that the dear Lord gives them an early release from mortal care.” 57
But Gleason’s control of her patients’ reproduction was all the more effective
because she offered an understanding ear to the transgressor:
32
While writing this chapter, a young wife called; she had a sick face, and eyes
expressive of great mental agony. “I have done wrong,” she said, “and am very
sorry; I have come to you for counsel. I had excellent health until a few months
ago, when my monthly period not coming so soon as expected, I began to be
fearful I was pregnant, and as we had two little children, and my husband’s
means are moderate, I did not want any more just yet; so I sent to the doctor to
give me some medicine to bring on my menses, thinking if I was in a family-way
it would do no harm, as it was only a few days over my time. The doctor said he
thought I was pregnant, and it was a pity to have another baby when this one
was so young, and that he would use an instrument to bring me around all right,
which would do no harm; that there was nothing wrong in so doing. I yielded,
and have never been well since.” 58
The patient offered her story without any urging or even a direct request.
Gleason is someone, at least in her own account, to whom the patient can
comfortably confess wrongdoing with the assurance that repentance will
bring forgiveness. Like Harriot Hunt’s disconsolate mother, she is cured
without any conventional medical intervention: “During this conversation,
hope dawned in her darkened countenance, and she said, ‘You have done
me good, and I will try to get well, and will welcome the little ones, few or
many.’”59 Like Meigs, Gleason wrote the story of the patient she hoped to
have. Like Meigs, Gleason expected to change the lives of her patients—
and in rather more substantial ways than by having them take long daily
walks. Like Meigs, Gleason did not represent her patient as offering any
serious resistance. But unlike Meigs, Gleason saw the patient’s story as the
initiator and the vehicle of cure.
Gleason’s account suggests that, while they practiced a conventional range
of therapies, women physicians also understood their medical practice as sup-
port for, and regulation of, motherhood. Conversation between the woman
patient and the woman physician negotiated the patient’s assent to mother-
hood and secured her participation in the transmission of feminine care from
mother to daughter. The woman physician served as a bridge, a supplement
for maternal care that might have been compromised, absent, or rejected by
the patient. Such a self-understanding was of course contradictory: it simul-
taneously ascribed to the woman patient enormous power, a psychological
equivalent of Professor Wallace’s “ovarian power,” and contained that power
within a social space so constrained that it seems sentimental to call it a
sphere.
In the regulation of motherhood, and in such other practices as child-
rearing, household economy, dress, amusements, and choice of occupation,
the heart history opened the subjectivity of women patients to the interven-
tions of their women physicians. Those interventions were both productive
33
and problematic. Neither Hunt nor Gleason nor Keller forced treatment
upon patients; none of their interventions would have been considered un-
ethical by nineteenth-century canons. In all these accounts, their willingness
to hear and understand their patients is palpable. While many patients did
confide in male physicians—we need only think of Thomas Kirkbride, direc-
tor of the Insane Department of the Pennsylvania Hospital—we cannot
simply discount the reports of both doctors and patients that heart histories
were more easily related to women physicians. And the therapeutic force of
the heart history is always invested in the physician’s response, in her educa-
tion of the patient to a deeper sense of responsibility or a livelier willingness
to take risks. In writing about such conversations, women physicians repre-
sented their hopes; the more quotidian narratives offered in hospital case
histories present a different image of the medical conversation.
IMAGINED CONVERSATIONS III:

HOSPITAL CASE HISTORIES
Surviving accounts of the medical conversation are not transparent records

of what passed between doctors and patients. Hospital medical records fol-
low their own generic constraints, and were designed to guide students, re-
cord treatment, or aid memory rather than to capture the give-and-take of
colloquial talk. These texts leave an indirect record of the conversation be-
tween the patient and a doctor and a record of the apprentice doctors’ edu-
cation as medical writers. I have drawn on such records in the archives of
two Philadelphia medical institutions: the Jefferson Hospital, a distinguished
male institution with a rich surviving archive, and the clinic and hospital asso-
ciated with the Woman’s Medical College of Pennsylvania, for which a nar-
row group of records has been preserved. These accounts are also doubtless
marked by the student writers’ desires to entertain or instruct an audience,
to look good in the story, to perform the role of the good student, and to
clean up and regularize the speech of all concerned. Nevertheless, they offer
the best sense we are likely to get of how patients constructed their bodies
and their illnesses and how male and female physicians inflected those
constructions.
Contemporary studies of doctor-patient conversations offer some guid-
ance for reading these texts, although they do not necessarily capture the
range of interviewing styles or take into account recent reforms in the con-
ventions of the medical interview. Contemporary ethnographers of doctor-
patient talk have recorded hundreds of hours of such talk and have tran-
scribed, annotated, and analyzed their data.60 Research has focused on the
diagnostic interview, structured by a series of questions asked by the doctor.
34
The doctor may simultaneously examine the patient and review his or her
medical records. Whether doctor or patient is male or female, the usual in-
terview lasts about eight minutes. The patient’s story is subject to possible
interruption when the doctor follows out a line of thought suggested by the
physical exam or asks a question prompted by its findings. In the interview,
doctors ask many more questions than patients, and their questions are al-
most always answered, while patients’ are sometimes ignored. Doctors’ in-
terruptions and questions often reestablish their control of the direction of
the conversation. And the questions asked by doctors differ from those asked
by patients. Doctors often chain questions together or offer a forced choice
(“Is this real pain or weakness?”). Answers to their questions can be inter-
rupted by new questions.61
Two stories struggle for the floor in a medical interview: the patient’s story
of illness and the doctor’s story of diagnosis. Each can interfere with, contra-
dict, or distract from the other. Patients want to tell stories, to articulate the
development and changes of their symptoms, while doctors use the interview
to pursue a serial and necessarily disconnected investigation of specific
themes:
D: How long have you been drinking that heavily?
P: Since I’ve been married.
D: How long is that? 62
Replies are interrupted when the doctor responds to what she feels or sees,
opening a new line of questions. The medical interview is inherently discon-
tinuous, since the patient experiences the symptom as a history, while the
doctor attempts to localize it within a segmented body. Over the course of an
illness, the dynamics of doctor-patient conversations change. During initial
consultations, the patient is likely to present relatively inchoate events, which
are negotiated into a diagnosis through subsequent interventions.63 During
these negotiations, in both subtle and marked ways, categories of power and
blame are invoked: patients are “good” or “bad,” innocent or responsible
for their illnesses, curable or not. These evaluations and other information
presented by doctors are taken in, misunderstood, or reorganized. Such
struggles and discontinuities are not surprising; it would be strange if a con-
versation initiated by a person who perceives something wrong in his or her
body, carried out in mixed registers of vernacular narrative and specialized
scientific knowledge and moderated by a highly trained and hurried profes-
sional, did not operate all the ideological and imaginary variables of gender,
class, agency, and family romance, did not provide rich resources for both
drama and fantasy.64
These contemporary studies foreground the strangeness of a ritual conver-
sation that we have learned to consider as normal. Foucault’s analysis of the
35
centrality of confession and surveillance in the formation of the early modern

subject suggests that these practices, developed in the clinic, were deployed
throughout the disciplined society.65 Although this account must be supple-
mented with a reconstruction of the agency of physicians and their patients,
the records of nineteenth-century hospitals offer striking images of doctors
learning to see patients through the lens of medicine, a formation that is
repeated as each new medical student learns to take a medical history.
Even in the most fragmentary records, traces of doctor-patient conversa-
tions can be found in nineteenth-century documents. And at the middle of
the century, it was not unusual to keep sketchy records, especially in hospi-
tals. (Marie Zakzrewska reported that male doctors were astonished that the
New York Infirmary for Women and Children kept written records on every
patient.66 ) But hospital clinics and dispensaries, particularly if they were as-
sociated with the Quakers, often kept a running record of cases, and students
kept notes for their own use. A casebook belonging to J. W. H. Reber, a stu-
dent at Jefferson Medical College in 1866, offers typically laconic notes on
physical examinations. The notes begin with the patient’s presenting com-
plaint and include short discussions of the present illness, a limited review
of systems, and a prescription. Reber does not often note a diagnosis; indeed,
in midcentury American medicine, such general diagnostic categories as
“dyspepsia” or “weakness” were quite common. A typical Reber note—we
could take it as the baseline of nineteenth-century medical narratives—
reads:
Woman. Spasmodic c cough, debility of respiration on left side. Congestion of
bronchial membrane. Treatment—Laudanum in very large doses, Dovers pow-
ders and ipecac [——]67
This rudimentary case note suggests that when the teaching physician pre-
sented the patient, he also specified complaint, diagnosis, and treatment.
Students may have listened to the patient’s lungs or may have been offered
a description of chest sounds. The prescribed treatment was a model for
their future practice. These elements—complaint, diagnosis, signs of dis-
ease, and treatment—are the minimal constituents of nineteenth-century
case notes. They can be inflected with very minimal variations: Is the patient
described as a woman or a lady? Is the patient’s age or nationality given?
How is the patient’s reproductive status noted? What is the relation between
the complaint and the diagnosis? Does the treatment assume an ongoing
relation with the patient, or is it understood as a single intervention? How-
ever, to trace out the signs of doctor-patient conversations, we must turn to
the more developed histories found in clinic notebooks.
The clinic notebooks, kept by medical students, were records of the medi-
cal and surgical clinics at which patients were given demonstration treat-
36
ment. The notebooks may have been reviewed by the attending physician or
his assistant, a post normally taken by a promising recent graduate. None of
the entries was signed, but the patient histories are free from blots or correc-
tions, suggesting that they have been recopied from rough drafts. Histories
are followed by periodic notes of treatment, usually medication, sometimes
in different hands. Often, although not always, the record ends with an ac-
count of the patient’s death or condition on release. One notebook from an
1853 Jefferson surgical clinic offers detailed accounts of various trauma pa-
tients; circumstantial accounts of their accidents are sometimes augmented
with fairly full medical histories and reviews of systems. We read, for ex-
ample, of one WW, identified as a “colored man”:
A house painter aged 43 years states that he fell from a ladder at 51⁄2 while
painting the second story window shutters of a house, the ladder then falling
across the right leg.
On examination I found a transverse fracture of the tibia just below the tuber-
cle and a longitudinal fracture dividing the tuberosities and running up into the
knee joint. The patient states that he has taken four drinks of brandy since 1
oclock and that he is in the habit of drinking porter for dinner every day; seldom
any stronger drink. He states that he has been in the habit of urinating very
frequently night and day for more than eight years otherwise he enjoys very
good health, never being much disturbed by this desire to urinate.68
After three weeks of painful treatment for his fractures, the patient observed
that “the quantity of his urine [was] beginning to increase a little,” and he
was found to be diabetic. He received the standard treatment—cod liver oil
and a diet of meat and milk—but began to fail; a month later, he was de-
scribed as “evidently sinking.” He died; what was interesting to this surgical
student, however, was his fractured leg. The bone was examined in an au-
topsy and found to be healed; his friends “demanded the body almost before
the wound was sewed up from where the bone had been taken.” The writer
finds the case “most interesting as showing that fracture into the knee at-
tending joint does not always involve amputation. The bone is a most valu-
able one and is in the hands of Dr. Norris but is the property of the Hospi-
tal Museum.” 69
This history recounts a battle between doctor and patient for the literal
ownership of the patient’s body and the analogous conflict between doctor
and patient over what counts as interesting. The patient’s completely un-
treatable diabetes did not blunt the surgeon’s triumph at having healed a
difficult fracture; his catastrophe was irrelevant to the physician’s technical
triumph. But beneath the official story, we can trace another series of con-
versations; it was WW himself who first advanced the theme of diabetes by
mentioning frequent urination and who raised the possibility of a diabetic
37
crisis by noticing increased urination. While the doctor experimented with

framing WW’s as a story of alcoholism, the patient’s account, sadly, became
salient and ultimately prevailed.70
Many of the Jefferson clinical notebooks record similar negotiations be-
tween doctor and patient: each partner advanced a frame for the narrative
of illness; and it was by no means a foregone conclusion that the doctor’s
would prevail. A notebook recording treatment in an unspecified clinic of
the Jefferson Medical College for 1866–69 offers the following account:
HR, Epilepsy
Monday, Nov. 4th, 1867. Aet 16.
History. Had convulsions since she was four years of age, with the exception of
two years from the 14th year to a few months ago. March a year ago was the first
appearance of catamenia—during the year before the catamenial change the
attacks ceased. For the last nine weeks menstruation has been irregular.
At first, the attacks occurred several times in a week; during the last three weeks
they have been daily. No aura of epilepsia but she knows when attacks are com-
ing on by a sensation of agitation. In the attack she becomes stiff, would fall but
generally gets to sofa &c. Bites her tongue to bleeding; good deal of spasm.
Attack lasts generally fifteen minutes. Screams at beginning: seldom goes to
sleep after spells.
Appetite poor. T.[ongue] not coated. B.[owels] regular.
Has good deal of head-aches. Sight good. Memory poor. Gait unimpaired.
Four years ago, following violent attack of epilepsy, had paralysis of left side,
which was marked for six weeks. Left hand still partially paralyzed.
No affection of heart.
Diagnosis. Epilepsy from organic brain change.
[Four prescriptions are written here.]
Monday, Nov. 11. No convulsion since Nov. 4th.
Monday, Nov. 25, 67. Had four convulsions since Nov. 11th, one Nov. 16th; two
Nov. 18; one Nov. 21. These occurred near setting in of menstruation, which has
been absent for three months.71
This account suggests how, in the course of the medical interview, patient
and physician negotiated control of the topic. In the first paragraph of this
history, the narrative of the patient’s complaint is scrambled and discontinu-
ous, moving from the first appearance of the complaint to the present, back
a year and then two years, and then to the immediate past. These scattered
remarks may well reflect two different stories, told by patient and physician.
The patient presents herself as having frequent epileptic attacks and tells
her story from its beginning: she has had continual convulsions with only a
brief period of relief at puberty. The doctor investigates the epileptic attacks
as related to the patient’s menstruation—an entirely conventional line of in-
quiry, but one which punctuates and syncopates the patient’s narrative by
38
reorganizing it around the onset of puberty and the regularity of the patient’s
monthly periods.
Both narrative lines are introduced in the first sentence of the history: the
patient “had convulsions since she was four years of age, with the exception
of two years from the 14th year to a few months ago.” The present illness is
framed: we know when it began, how long it has continued, and how it is
situated in relation to the “now” of the interview. The physician’s inquiry then
unfolds episodically while the patient answers his questions. The narrative of
this paragraph is both fragmentary and doubled, with the patient’s account of
her seizures (“since four years,” “with the exception of two years,” “a few
months ago”) laid over the physician’s reconstruction of her menstrual history
(“March a year ago,” “during the year before,” “for the last nine weeks”).
In the second paragraph of the history, the patient responds to a request
for information about the seizures, and the narrative vectors become strong
and direct. The story is located in time and space: the attacks happened in
rooms with sofas, and they were seldom followed by sleep. The patient’s
consciousness provides narrative focus: she knew when an attack was coming
and screamed at the beginning. This patient had substantial narrative re-
sources and got on record an account of her epileptic fits that ignores the
diagnostic terms that the physician put in play: she did not have an epileptic
aura, but she just knew when a fit was coming on. Her account is augmented
with information that she herself could not have known directly, which could
have been supplied in the interview by an accompanying relative or which
she could have heard from her family: she bit her tongue, the fits lasted
fifteen minutes.
This remarkable history is followed by a review of systems and what ap-
pears to be a simultaneous physical examination; the doctor inquires about
the patient’s digestion and inspects her tongue, eliciting the further history
of her paralysis. Such a comprehensive review of systems would be, for a
contemporary analyst, axiomatically associated with a lack of clinical experi-
ence.72 The initial diagnosis of epilepsy is confirmed, the patient is given
a prescription, and she returns for several subsequent Monday clinics for
desultory investigations of the relation between her epileptic seizures and
her menstrual periods. Those investigations never become conclusive, are
never resolved; the story of reproductive disturbance that the physician was
attempting to tell withers away, while the patient’s robust tale of nervous
disorder organizes her treatment.
This sixteen-year-old patient was quite adept at directing the course of
the interview and went on record with an account of her experience as she
understood it. The line of investigation that mid-nineteenth-century medical
practice would have suggested never got off the ground; the doctor’s story
of convulsions related to a menstrual disorder was encapsulated, as it were,
39
in the segmented time of the initial paragraph and was never integrated into
the story of this illness.
At other times, the voice of the patient is firmly elided. Returning to the
laconic clinical notebook of J. W. H. Reber, we read of the following case of
“Mania-a-Poter”:
Patient—Male. Diagnosis. Man habitual drinker suddenly stopping to drink, on

account of superstition. Taken with disease two days ago. Violent motions of
body, with screaming; destroying everything about him. Talking nearly all the
time, with various images before him.
Treatment. First approach with caution, talk gently to him, and gain confidence,
if that will not answer strapping to the bed or floor must be resorted to.
Then a stimulating treatment combined with narcotics.
Whiskey then a narcotic (morphia) to bring on a gentle sleep.
Digitalis or veralium veride when the pulse is too strong and numerous.
Beef tea and a nourishing diet.73
This account speaks of the patient “talking nearly all the time,” but we have
none of his words, no idea which “superstition” prompted him (foolishly, in
the eyes of the physician) to stop drinking. The central voice in this account
is that of the professor, who delivers the case as a series of imperatives to the
medical students. The lecturer’s presentation is relentlessly didactic in its
control of the narrative voice; the student’s attention is directed to a story of
treatment in which the delirious patient, whether by cautious talk or by forc-
ible restraint, is subdued to a gentle (and alcoholic!) slumber. The doctor’s
talk is a device, a way to quiet the patient. Unlike Keller’s maniac, this patient
passes silently before us; we have only a record of the noise he made, “de-
stroying everything about him.”
What is common to all of these Jefferson cases is the doubled frame that
emerges in any but the most elliptical case record. Sometimes control of the
treatment remained in the hands of the doctor, as in the case of delirium
tremens, where the patient’s frame is only indicated (“on account of supersti-
tion”). Sometimes, the patients’ framing of their condition prevailed in fact,
but a different frame organized the medical narrative, as with the diabetic
house painter. Sometimes both frames remained inconclusively active, as
with the sixteen-year-old epileptic. While none of the doctors writing these
cases was interested in the patient’s heart history, in none of them is the
patient’s voice simply silent. These histories confirm that, when physicians
like Meigs recounted conversations with patients who simply surrendered to
the physician’s guidance, these physicians were offering not only their hopes
but also their fantasies. The patients who actually presented themselves in
clinics and hospitals were much less tractable interlocutors.
It is difficult, but possible, to juxtapose these texts with surviving records
40
of the conversations between women doctors or medical students and their

patients. The student records we have from the Woman’s Hospital of Penn-
sylvania, the clinical facility associated with the Woman’s Medical College,
are not comparable to Reber’s notebook. Rather, they are patient histories
taken on admission to the Woman’s Hospital, roughly comparable—with
some important differences—to those preserved in official notebooks at Jef-
ferson. These are hospital rather than clinic records; only women patients
were admitted, and no trauma cases came to the hospital. And, a “clinic
book” ascribed to Dr. Kersey Thomas survives from the early years of the
Woman’s Medical College. In 1852, before the foundation of the Woman’s
Hospital, the Woman’s Medical College operated a clinic; since women stu-
dents were barred from all the hospitals and clinical lectures in the city, the
clinic was their sole opportunity for bedside training. In the clinic book,
Thomas, the attending physician, and two student clerks recorded patient
visits and treatments for 1854–55.74 Case notes in the clinic book could be
both terse and opinionated; they were not dutiful students’ memoranda but
the professor’s extensions of clinical teaching. Dr. Kersey Thomas’s account
of a patient seen January 20, 1855, for example, reads: “MM [address] Aet
70. Escaped being victimized by Wall’s mag. syrup. Old adhesions in the ant
and lower portions of pleura of both lungs. Present disease bronchial irrita-
tion extending as low as upper third of right lung. Treatment Hives syrup as
a tonic.” 75 Another prescription follows. This patient is presented pedagogi-
cally as someone the class should rescue from quackery. Like Reber’s laconic
account of a patient with spasmodic cough, the note focuses on what is gen-
eralizable in the case.
We might distinguish Reber’s note from Thomas’s by looking closely at
each text’s deictic system. For text linguists, deictic system refers to features
of language that are oriented to a particular speaker and her audience; the
deictic system includes pronouns (I versus you); demonstrative adjectives
(here versus there), demonstrative pronouns (this versus that), and verb
choices (come versus go). By extension, we can speak of a text’s deictic system
as including everything that orients reader and writer both to one another
and to a series of objects constructed in the discourse; the deictic indicates
points of readerly attention and establishes their boundaries. If nineteenth-
century medical education can be seen as moving from discursive, text-based
teaching to practical, clinical teaching, that development emerged in the lan-
guage of the classroom as the articulation of a more directly demonstrative
deictic system. The discursive teacher speaks about something (“Typhus has
three symptoms”), while the clinical teacher shows something (“Note the
three symptoms of typhus in this patient”). Later, in the practice of Mary
Putnam Jacobi, we will meet an exuberant development of textual deictics;
in reading these earlier examples, we might ask first of all what objects are
41
being pointed out and what relationship they construct between reader and
object. In the example from Jefferson Hospital, the patient with spasmodic
cough is written up by Reber as a series of signs and symptoms; his attention
focuses on what is generalizable in the patient and what is replicable in the
patient’s treatment. The patient at the Woman’s Medical College clinic is
articulated, however, in a narrative of professionalism; she demonstrates
what it is to be treated by a quack, what constitutes bad practice. Reber’s
account orients the student to the patient; the clinic book orients her to
professional practice: the Woman’s Medical College student should imitate
Thomas rather than the quacks who dosed the patient with Wall’s syrup.
Such imitation and the identification that might support it would have been
read as signs of women’s capacity to take up and pass on the knowledge of-
fered by their teachers, a capacity that, in mid-nineteenth-century Philadel-
phia, was in doubt. Thomas’s note suggests that his readers would become
like him, impossible as that might have been in the nineteenth-century gen-
der economy, that they would not become like some lesser physician, and
that their coughing patients would benefit from that transformation.
Another unsigned note, probably also by Thomas, records the treatment
of a Mrs. D., aged twenty-two:
Disease cancer of rectum of many years standing. Mistaken by other physi-
cians for hemorrhoids who treated it by ligatures, secharatics etc, increasing its
growth and prostrating the sufferer.
Becoming a clinique patient Jan 15th. Treatment sedative and tonic. No hope
of cure. Her strength is gradually giving way before the march of her fatal dis-
ease. Swelling of the limbs. Buboes in inguinal region with transient neuralgic
pains in various parts, mark its course. Pain and irritability of the part allayed by
local applications of nit. silv. Constitutional treatment. Quinonia alternating with
Iron tr. Opium to obtain rest with nutritious diet.
By this plan of treatment her sufferings have been allayed and life made
more endurable.76
The note records continued treatment with palliatives until the patient died
on March 12; the body was autopsied, and the tumor “preserved in the col-
lege.” (The Woman’s Hospital, like Jefferson, was constructing the “patho-
logical cabinet” that was, for scientifically advanced hospitals, a step toward
close study of how disease affected particular organs and tissues.) Like the
victim of Wall’s syrup, this patient was presented as having been mismanaged
by other physicians. The note began with a diagnosis rather than a presenting
complaint, moved to a wry history of the patient’s mistreatment, and then
projected the difficult future that Thomas would attempt to soften. The note
itself articulated a very complex time frame: the treatment was presented
both projectively, as something that would only slow “the march of her fatal
disease,” and also retrospectively, “her sufferings have been allayed.”
42
Thomas’s narrative might have allowed students to read the patient retro-
spectively while they were treating her; this patient was one of the few who
arrived at the clinic with a serious illness, and her treatment may have been
difficult for the students. Or the note may have been edited and transcribed
after the patient’s death. Thomas, deploying a scientific deictic, directed stu-
dents’ attention to physical signs, relating the progress of the patient’s neural-
gic pain to the course of her cancer, and prompted them to integrate their
knowledge of those signs to a professional habitus that would have avoided
her early misdiagnosis. The case narrative, therefore, maps out both a body
(“in inguinal region,” “in various parts”) and a therapeutic practice (“local
applications,” “to obtain rest,” “this plan of treatment”).
A final history, by an unidentified writer, is quite singular:
July 11th //55 Mrs. M. M. age 32.

Sick with poverty and general illness [this sentence struck out.]. Probable pro-
lapsis—though no manual examination. Complains of pain in left side between
fourth and sixth ribs and of general lassitude with the usual symptoms of pro-
lapsis on standing.77
The transgressive general diagnosis, “poverty and general illness,” survives

clearly under erasure; it is possible that the student clerk wrote this sentence
and that the attending physician struck it out. The conventional diagnosis of
prolapsed uterus is supported by the patient’s complaint and is assimilated
into the “usual symptoms”; it is as if the writer herself had very little faith in
the efficacy of the diagnostic system she was operating; her encounter with
poverty and disease was not at all convincingly mediated through the diag-
nostic routine of searching for uterine displacement.
The Woman’s Medical College clinic book records conversations, not be-
tween doctors and patients, but between Thomas and his students. It shows
how he directed their attention to the patient as someone who had been ill-
served by the profession that these students were about to enter. In all three
of these notes, we read criticisms of current medical practice—an entirely
regular refusal of quack medicines, a complaint against the previous treat-
ment of a patient, and a transgressive diagnosis. The comparable clinic books
from the Jefferson Hospital show no similar criticism of current medical
practices.78 Instruction at the Woman’s Medical College, then, may have
been seen, at least by Thomas, as oppositional to conventional medical prac-
tice. The clinic was understood as a refuge to patients suffering from self-
dosing or conventional medicine. This sense of the institution as insurgent,
however unsupported by distinct strategies of treatment, would have in-
formed students’ self-understanding as new doctors, different from those in
practice, but better. We shall encounter this dissenting voice again, in the
theses written by students at the Woman’s Medical College. Much more dis-
43
tinctly than any expression of care or connection, a willingness to criticize

conventional medicine, to hold themselves at a distance from the profession
they were joining (or training others to join), separates the students and
teachers at the Woman’s Medical College from those at Jefferson. Although
similar critical reflections marked the rhetoric of irregular schools like the
Penn Medical University, they are extremely rare in the institutional dis-
course of regular medicine.
The clinic books from Jefferson Hospital and those written at the Woman’s
Medical College clinic, however, are similar in important ways. All of them
offer an account of the patient’s chief complaint, history, current illness, and
treatment, although sometimes in unconventional order.79 The cases in all
the clinic books are organized as teaching exempla: The accounts draw stu-
dents’ attention from physical signs to an understanding of the causes and
the progress of disease. They record the treatment of particular patients for
particular, limited audiences, and they are also directed toward the readers’
future treatment of similar patients. In the clinic books of both hospitals, the
student’s attention is focused on signs of disease rather than on the general
“system” of the patient. While none of the clinic books were published, all
were used, even disseminated; the medical student Reber kept his clinic
notes throughout his career, and all members of the class at the Woman’s
Medical College would have read the notes provided by Thomas and the
clinic clerks. The writer, whether a student or a physician, offered the written
history in its unblotted penmanship, regular phrasing, and the proper perfor-
mance of professional habitus as evidence of fitness for the profession or as
a model of professional performance to which students might aspire. As the
conventions of French clinical medicine became more widely accepted, the
individual patient history was put to different use: when doctors ceased to
explain disease as a breakdown in the patient’s general constitution and
began to diagnose specific illnesses as disorders in physiological processes,
the patient’s medical history ceased to be an investigation of his diathesis,
or predisposition to disease, and became a tool in differential diagnosis or a
means of coordinating the work of health care providers.80 Even more dra-
matic changes in the hospital record followed the dissemination of German
systematic rationalism: if illness was seen as the quantifiable divergence of
some discrete system from its normal parameters, then the hospital record
could plausibly be reduced to a telegraphic series of measurements of pulse,
respiration, temperature, and laboratory results.81 Hospital case records then
became operational rather than demonstrative; they were vehicles for or-
ganizing the care of individual patients, of limited pedagogical value. The
story of illness they told would (they hoped) be enacted as the patient was
treated and responded to treatment—the happy story relentlessly inscribed
44
in such contemporary charting conventions as “problem-oriented records.” 82

If we move from the brief records of the clinic books to the early accounts
of patients at the Woman’s Hospital of Pennsylvania, we can trace the early
stages of this transition as it was inflected by a women’s institution. The pa-
tient histories taken at admission to the Woman’s Hospital during its first
years of operation, in the late 1860s, were often gnomic and never as candid
as the earlier clinic accounts. But these vivid case records offer a lively sense
of the new institution’s entry into practice.
No. 540
Admitted June 16th, 68
MN—mother of a family had been suffering for about ten days from abundant
sanguineous discharges, dependent upon the abortion of a three months ovum
and the retention of the placenta. The placental mass was found protruding from
the os uteri: but so soft and friable that it broke down under the slightest touch.
It was removed in successive portions by the fingers and the placental forcep.
Discharges ceased. Wine of Ergot and Serringinous tonics were administered
and the patient was discharged June 18 in satisfactory condition.
No. 542.
Admitted June 17, 68
AS had just been delivered of a child in a station house on her way to the hospi-
tal. Suffered no inconvenience from the journey. Made a rapid recovery and was
discharged in satisfactory condition June 30.83
From the fall of 1868 until 1875, students at the Woman’s Hospital were
taught to take more formal comprehensive histories and to perform detailed
physical examinations. The prescribed form used in these histories seems
to have encouraged a particularly open conversation between the student
physician and the patient, in which the patient located herself in her family
and personal history and in which her understanding of her condition was
given remarkable weight. Although the topics of the history were conven-
tional, their arrangement was not. The interview began with inquiries about
the patient’s family, investigating the health of her parents and siblings. Next,
her age at first menstruation and her subsequent menstrual history were de-
termined; the patient evaluated her general health and gave her history of
pregnancy and births. Only then was her present complaint determined and
the story of her current illness told. Upon admission, the patient was exam-
ined: pains were specified and located; tissues and orifices inspected; glands
palpated. Pulse, respiration, and bowel movements were investigated, and a
urinalysis was done.84
Consider the following history of a young woman of eighteen who came to
45
the hospital complaining of paralysis in September 1875; the assistant E. H.

Pollard took her history:
Married. Bookfolder by occupation. Mother of one child. Both father and
mother died of consumption. Brother and sister living. She commenced to men-
struate at 14. Was regular up to pregnancy. Patient reports good health up to
birth of child. Baby born May 1st, 1875, one hour’s interval between rupture of
membranes and expulsion of child, had pains for six days—baby weighed 10
pounds. She had severe frontal headache for four days after confinement, fol-
lowed by many convulsions with unconsciousness of nine days, so that patient is
unable to give a very accurate account. On recovering consciousness, there was
more or less paralysis of all the extremities and tongue, but none of the face.85
Two days after admission, the patient was examined, and among other notes,
the physician reported that she “can dress herself, but cannot comb her hair
on account of weakness at wrist.” The patient was diagnosed as suffering
from a prolapsed uterus, retroversion, and endometritis, treated by medica-
tion and faradization, and released five weeks later, “improved.”
Although it was an internal examination that determined both the final
diagnosis and the treatment of this patient, the patient’s diagnosis and treat-
ment rest on her own account of her condition. Her paralysis is reported as
she might have described it, in terms of what is easy and what is hard for her.
The doctor listened to the patient’s account of her illness and incorporated it
into her history; uncorrected and unembellished, at precisely the time when,
in many hospitals, such transcription of the patient’s language was becoming
rare.86 The history’s account of the onset of the patient’s illness is limited to
what she herself knew directly. We have a full and circumstantial account of
her labor but no idea what happened during the nine days when she was
unconscious.
Another history, taken in 1876 by A. L. Brindle, demonstrates a collabora-
tion (or perhaps a contest) between physician and patient to describe the
patient’s course of illness. The patient was thirty-nine years old and would
be diagnosed with uterine fibroids:
Family History. Father died phthisis pulmonalis. Mother living but affected
eventually. Has had two brothers and four sisters; all died when young.
Began to menstruate when 16 yrs old: has always been regular. Was married
when 18; had one abortion when 4 mo.s pregnant. Patient was always healthy
till 5 yrs ago when she began to feel tired and weak constantly: also had pain in
left lumbar and iliac regions: suffered great pain during menstruation for more
than one year; pain then ceased. About three years ago she noticed that her
abdomen was growing larger. One year ago Patient had pneumonia. About four
months ago she again had pain during menstruation. About 3 mo.s ago, patient
noticed a blood discharge from the bowels: also had watery discharges from
bowels. These periods of discharges alternate with periods of constipation. Dur-
46
ing periods of discharge she has soreness over the epigastrium and everything
she eats distresses her, after making her deathly sick and causing her to vomit.87
The comparable history of the young epileptic at Jefferson suspends two

competing narratives of illness—a sequential narrative associated with the
patient and a retrospective narrative constructed by the doctor. This Wom-
an’s Hospital history simply adopts the patient’s narrative frame, and we read
a continuous story told in her terms.
The lexicon of the history is also collaborative. The patient’s story is some-
times translated into medical language, as in pain in left lumbar and iliac
regions. At other points, the language hovers between technical discourse
and ordinary talk: the ordinary reader of medical advice would know such
expressions as periods of discharges alternate with periods of constipation, a
phrase that could have been uttered by either physician or patient. And there
are also moments when the colloquial register takes over: we do not know
whether the patient herself said that her food made her deathly sick or
whether her description elicited that vernacular evaluation from the medical
student; in either case, colloquial vigor has overcome any attempt at tech-
nical precision. This history is a narrative deploying both ordinary talk
and a specialized medical vocabulary to construct the story of an illness. Such
mixed registers are, in contemporary practice, common in the histories writ-
ten by inexperienced medical students, and it is possible that Brindle’s tran-
scription of the patient’s story and language was as much a sign of her inexpe-
rience as an expression of the Woman’s Hospital’s orientation toward its
patients.88
The Brindle case is not an isolated example, and the stories offered by
patients could shape the more scientific sections of their histories. Some pa-
tients’ theories as to the causes of their illnesses are reinscribed in the his-
tory. Such a history was written in 1876 about a patient who was a visitor
from Cincinnati, born in Prussia; Emma Gaslow was the hospital assistant,
but the history is not in her handwriting.
The patient’s parents are living and healthy, she has three sisters and two broth-
ers living and well.
The patient commenced to menstruate in her fifteenth year and has always
been regular, with the exceptions of her pregnancies. She was healthy until the
last two years. She has given birth to three children; the first of whom is living
in Germany and is healthy, the second child died at six months of age from
some enteric disease, the third child was premature and still born. The patient
menstruated last in January, 1876 and she believes herself to be pregnant now.
During June and July of this year had some kind of a fever, but she was not sick
enough to be confined to her bed. She continued to work, but had attacks of
dizziness, and at one time, some three weeks since she became unconscious and
fell in the street. The physician attributed said attack to weakness, dependant on
47
her condition. During her convalescence she says she passed three days without
voiding urine, from inability to urinate, and from the time of that distention of
the bladder she dates the cystitis.
Here, the examining doctor translates the patient’s history into technical
terms, so that her dead child suffered from some enteric disease. But the
patient herself specifies her current state (believes herself to be pregnant
now), gives the cause of her illness (from the time of that distention of the
bladder), and offers the report of her former doctor’s diagnosis (weakness,
dependant upon her condition). All these critical elements of the history are
ascribed to her, whether the precise words are hers or not. The patient has
presented herself as a complete package, with a history, a record of consulta-
tion, a diagnosis, and a theory as to the cause of her illness. That package
survives, more or less intact, in the official history. The examining doctor did
verify pregnancy by measuring the fundus of the uterus and examining the
breasts for milk. She treated the patient for a month with medication but
never quarreled with her diagnosis or the story she told.89
Compared with the clinic notebooks from Jefferson Hospital, these cases
offer a much more direct sense of the patients’ speech, of their own stories
of illness, and of their negotiations of their cases with physicians. These
differences may be more—and less—than simple reflections of gendered
conversation styles. After all, many of the Jefferson patients had suffered
traumas; the notebook presents a florid collection of nineteenth-century in-
dustrial, shipboard, and traffic accidents, none of which encouraged relaxed
or expansive conversation. Further, the specific inflection of this medical
genre practiced at the Woman’s Hospital was extremely hospitable to patient
narratives; the assistant’s first questions located the patient in her family and
placed the current illness in the context of a life lived among others. Rather
than opening with the current illness, so that the patient’s history is organized
around the presenting complaint, the histories elicited at the Woman’s Hos-
pital take their own course, knitting together relevant and irrelevant events.
Finally, the separation of the physical examination from the history offered
the patient greater control of the illness narrative; the physical signs of illness
are first inscribed as they are perceived by the patient and only later verified
or augmented by the physician.
These modest and relatively formal differences in the ways that patients
were encouraged to speak represent a difference in medical practice, if not
a difference in medical care, that characterized the day-to-day work of the
women physicians associated with the Woman’s Medical College of Pennsyl-
vania; there is some evidence that similar norms characterized the work of
women physicians at the Boston school, with which the Woman’s Medical
College was associated.90 It is important to emphasize that we are dealing
48
here with a difference, not necessarily an improvement; both good and bad
therapeutic regimens can either accept or ignore patients’ understandings
of their illness, although many readers of this book will share with me a cur-
rent cultural preference for patient collaboration and education. In terms of
nineteenth-century medical techniques, these 1868–75 admission histories
at the Woman’s Hospital are as remarkable for their consistent urinalyses,
counted pulses, and temperatures given in degrees as for the relation they
suggest between doctors and patients. But rhetorically, this difference in re-
lationships is extremely significant, suggesting that as medicine was elaborat-
ing its professional and scientific practices and working out the relations be-
tween them, more than one model of how doctors and patients might talk
was in play. The conversations between young doctors and their patients at
the Woman’s Hospital of Pennsylvania suggest possibilities of a more collabo-
rative and open relationship between the doctor and patient, broader possi-
bilities for the construction of medical knowledge, and a democratization of
expert competence. The fact that these possibilities distinguished a practice
that also used the most advanced technology available suggests that neither
the triumph of clinical empiricism nor the later hegemony of experimental
physiology need have come at the expense of traditional medicine’s attention
to patient stories.
AFRICAN AMERICAN WOMEN PHYSICIANS

AND THE MEDICAL CONVERSATION
If gender was a vexed issue in conversations between doctor and patient,

race could be even more intractable. We have seen how WW, the diabetic
patient at Jefferson, contested his doctor’s story of triumphant surgery and
how his family continued his resistance when they claimed ownership of his
body. Such misdirections were common in interactions between African
American patients and white doctors. Toward the end of the century, the
African American physician Rebecca Cole wrote for the clubwomen’s publi-
cation The Woman’s Era an account of W. E. B. DuBois’s report on his re-
search for The Philadelphia Negro. DuBois had argued that African Ameri-
cans suffered high mortality rates from consumption because they were
ignorant of hygiene. Cole countered that high rates of consumption among
African Americans were artifacts of white doctors’ unwillingness to take the
histories of African American patients. She observed that “hosts of the poor
are attended by young, inexperienced white physicians. They have inherited
the traditions of their elders, and let a black patient cough, they immedi-
ately have visions of tubercles, let him die, and he writes “Tuberculosis” and
heaves a great sigh of relief that one more source of contagion is removed.” 91
49
While white physicians could be unwilling to listen to stories of African

American patients, these patients continued to prefer white doctors to the
newly trained African American professionals. A survey of the Baltimore Af-
rican American community in 1882 showed that only 1 percent of insurance
holders used African American doctors.92 And given the role in which white
regular medicine cast African American doctors, such reluctance was under-
standable. Pioneer African American physicians were seen as emissaries,
bringing the gospel of hygiene rather than the most advanced medical care
to the African American poor. Just as women caregivers were considered
suited to the work of having “comfortable” conversations on difficult matters,
African American physicians were assigned the difficult work of hygienic
proselytizing. Rebecca Cole herself began her careeer as a “sanitary visitor”
attached to the Blackwells’ New York hospital. As Elizabeth Blackwell wrote
in her autobiography, Rebecca Cole’s work was to “give simple, practical in-
struction to poor mothers on the management of infants and the preserva-
tion of the health of their families.” 93 While Cole might well have sought out
just such an engagement with the New York African American community,
in Elizabeth Blackwell’s appreciative account no hint remains of the young
woman who had excelled at the rigorous curriculum of the Institute for Col-
ored Youth, with its required courses in Latin, Greek, and mathematics.94
And at Cole’s graduation from the Woman’s Medical College, Mary Scarlett,
the commencement speaker, implied that, while valuable, work such as
Cole’s would not be the best possible use of a woman’s medical education.
Scarlett conceded that
could proper hygienic influences be brought to bear upon the denizens of filthy
localities; could they be induced to cleanse their houses, alleys, streets, and their
own bodies and apparel; to open their windows and admit freely the pure air,
cook their food properly, and obey well-known laws of health, a much better
condition of both mind and body would be secured. . . . If any lady graduate
feels that it is peculiarly her mission to labor among this class of people, or that
she can in this way make herself more useful than in any other, let her enter into
the labor, realizing that “each individual in this world has a work to perform
which no other person can do so well.”
But she declared:
Ladies, this is not the chief end and aim of educating women medically. A great
need is felt in society—in all classes of society—for competent medical advisers
of the same sex. It is among the most sensitive, pure and refined, whether rich
or poor, that your professional skill will be brought most into requisition.95
We have only fragmentary and indirect accounts of what the work of a

sanitary visitor might have been like; the work of Rebecca Lee Crumpler
50
is a valuable source for reconstructing those interactions. Rebecca Lee

Crumpler was the first African American woman physician; she graduated
from the New England Female Medical College in Boston (1864) over the
objections of some faculty, who, “owing to the deficiencies in the academic
education of Mrs. Lee and the slow progress she has made in her profes-
sional studies . . . have hesitated very seriously in recommending her.” 96
After graduation, Lee practiced in Richmond, Virginia; she vanished from
the historical record and has only recently been identified as Rebecca Lee
Crumpler, who practiced in Boston and then in Hyde Park, Massachusetts.97
In 1883, Crumpler published A Book of Medical Discourses in Two Parts,
the only book by a nineteenth-century African American woman physician I
have been able to identify.98 (See figure 1.) Crumpler’s practice was oriented
toward the care of children, and her Book of Medical Discourses focused on
infant care. Crumpler presented the book as a revision of her “long-kept
journals,” although its thematic organization suggests that any journal entries
had been thoroughly reworked. The Book of Medical Discourses is a work of
sanitary education by other means; it also serves as a tool for basic literacy:
I desire to present different subjects by the use of as few technical terms as

possible; and to make my statements brief, simple, and comprehensive. Indeed
I desire that my book shall be as a primary reader in the hands of every woman;
and yet none the less suited to any who may be conversant with all the branches
of medical science. If women are permitted to read and reflect for themselves,
it is hardly possible that they will say it is uninteresting to them, or that it should
only be read by men.99
Crumpler’s Medical Discourses records her half of the remarkable medical

conversations that she had with patients; she is extremely frank in her recog-
nition of the material difficulties they faced. We read: “It is just as important
that a doctor should be in attendance before the birth of a poor woman’s
child as that he should be present before the birth of the child of wealth,” of
the “custom of old-fashioned people, as they style themselves, of giving new-
born babes castor-oil and molasses, or soot tea (for that irrepressible belly-
ache), and urine and molasses, to clean them out,” of children entrusted with
the care of a younger brother or sister, of hungry children given a meat rind
to chew, of children who failed to thrive because their mothers were under-
nourished during pregnancy, and of the difficulty of treating cholera with a
change of diet, since “the expenses of the articles mostly ordered by physi-
cians render a trial almost out of the question,” of a seamstress working a
treadle machine who “allows herself but little time to eat or sleep. And, what
is more than all, [she] frequently gets angry with the machine, unstrings it,
and gets it in as bad condition as she has her own nerves.” 100 Crumpler wrote
for readers who could not simply resolve to “obey the well-known laws of
51
Figure 1. Title page of Dr. Rebecca Lee Crumpler’s Book of Medical Discourses in Two Parts
(1883), the only known book by a nineteenth-century African American woman physician (Pho-
tograph courtesy of the History of Medicine Division, National Library of Medicine, Washing-
ton, D.C.)
health,” in Mary Scarlett’s words, but who contended with a radical shortage
of all the means of health, including information.
In the face of this shortage, Crumpler offered, first, the succor of her
book, pointing out that “books on the laws of health . . . could never injure
the mind and morals; but would, if read aloud in the family circle half as
often as trashy novels are thumbed over, prove a blessing more lasting than
gold.” Crumpler spoke in a familial voice, which also rectified the times when
she had been silenced, giving the advice she longed to give “at times, and
places, that it was not deemed my business to speak.” 101 When she did speak,
Crumpler did not mince words. She described treating a sick infant:
About a dozen years ago a neighbor of one of my patients, thinking it for the
best, gave catnip tea to her three-days’-old son. I was hastily summoned, and on
arriving in the room where everything a few hours before was so tranquil, I
suspected that catnip tea had been around. Of course no one would own up
until, after I had staid by the little victim fifteen hours without sleep, finally
succeeding in checking the frequent discharges and thus saving the child’s
life,—shame caused the disclosure of the cause of the mischief. The tea had not
been given for food, as the mother had a full supply; but as the babe was moving
about, it was thought that a little catnip tea would make it sleep.102
This passage echoes with Crumpler’s colloquial assertion that “catnip tea had
been around” and places her as an untiring investigator, whose discovery of
the cause of the illness parallels her heroic care of the child.
But in the Medical Discourses, objects are as eloquent as either the doctor
or the patient. In her attention to the material surroundings of her patients,
Crumpler evokes household goods with remarkable vividness and specificity.
She wrote of the newborn’s first bath, with “a great cake of perfumed soap
purchased long, long before, for the occasion.” 103 (Crumpler herself recom-
mended using melted lard or sweet oil rather than alkaline soaps.) And, with
that soap, we encounter the parents’ hopes for the baby, their preparations
for the birth, the social ceremony of the first bath. In her “better mode of
washing the new born,” Crumpler urged that the baby be kept covered with
a white wool blanket, “not necessarily new, but pure, never having been used
about fever patients, or about the dead.” 104 The baby enters a world of scar-
city and limit, where objects carry the history of death and disease. The care-
giver will protect the baby from those possibilities, even when the world
around it cannot be made new but only, and provisionally, pure.
Crumpler’s book is virtually silent about race; she never mentions her own
race directly and refers to it only by implication in a late chapter, where we
read, “The laboring men of my race, generally speaking, take much better
care of the horses intrusted to their care than they do of their own health.
Were men just as particular about what they themselves eat and drink, and
53
how they dress and sleep, the deaths of young men of thirty and forty years
would not be so common. Those who are not careful of their health die early
in this climate, and their offspring die earlier.” 105 In a letter included in the
National Library of Medicine’s copy of Medical Discourses, Crumpler speci-
fied her purpose as the general “prevention of pauperism” rather than any
project of racial improvement. (See figure 2.) Race was, and was not, central
to Crumpler’s medical practice, just as gender was, and was not, central to
the practice of white women physicians. Her book offers us a densely medi-
ated account of nineteenth-century doctor-patient conversations: talks con-
strained by the perceived contradiction between race and medical skill,
shaped by mutually acknowledged conditions of scarcity and misinformation,
talks in which the implements of care speak of their own history.
MEDICAL CONVERSATION AND THE CONSTRUCTION

OF GENDER
Medical conversations took place in the presence of the patient’s suffering

body; they were among the physician’s central means of establishing both
authority over and care of that body. They were therefore affected by all the
social forces that mediated authority: class, race, education, and gender. Also
in attendance, real or virtual, were the patient’s family, the doctor’s sense of
good medical practice, norms of “decency,” and a flock of curious medical
students. In that setting, the medical conversation offered doctor and patient
both singular resources and limitations. If the patient were female and the
doctor were male, the patient also often faced an intractable double bind:
she must speak freely to the doctor about her reproductive organs, parts of
her body that she should not otherwise name. But that impossible speech
situation also offered the patient resources of indirection, silence, and eva-
sion, strengthening her formidable powers of determining the conversation.
The doctor, for his part, was expected to maintain authority over the patient,
standing as surrogate for the more proper authority of husband or father.
If the female patient were treated by a female physician, she would have
had a wider scope for telling her story; it is certain that she faced a less
constricted speech situation. In some circumstances, the woman patient
might also have been able to incorporate her story into the narrative that
directed her medical treatment or been able to tell a story in which previous
doctors had been mistaken or inattentive. But the greater freedom of speech
offered by such settings also increased the avenues of subjection and control:
the understanding woman physician who heard her patient’s heart history
could also regulate her family life and her reproductive behavior. And the
physician, male or female, African American or white, could take up the role
54
Figure 2. Letter from Rebecca Crumpler to “Mrs. Stone,” from the National Library of Medi-
cine’s copy of her Book of Medical Discourses (Photograph courtesy of the History of Medicine
Division, National Library of Medicine, Washington, D.C.)
of interrogator or refuse the patient’s explanation. Patient and doctor were

implicated in relations of exchange and inhabited a favored scene of fantasy.
Physicians fantasized utterly compliant patients; patients fantasized utterly
attentive physicians.106
As a gender performance, the woman physician’s role was complex. Her
presence in the profession was justified by the difference that made her
problematic: patients would feel comfortable talking to her about things they
would not discuss with male doctors. But, as a student being trained by male
physicians, the woman doctor had to shape a way of being a doctor that was
like her teachers’. For some students, in some places, the social dissonance
of gender could be displaced in a strategy of cross-dressing; the woman
physician was remarkable, not because she was a woman, but because she
avoided the errors of conventional medicine—even though her practice was
otherwise quite conventional. For the established woman physician, an open-
ness to the patient’s heart history placed her as a regulator of the patient’s
morality and religion, a role that does not seem to have been problematic
for nineteenth-century women physicians. Nineteenth-century women phy-
sicians were defined as different from male doctors; patients were invited to
experience their therapy as distinct. And clearly, some women physicians
talked to their patients differently, wrote their patients’ histories differently,
and performed the discourses of medicine in a style that allowed them more
access to—and more control over—patients’ subjective experience.
56
3
Invisible Writing I
Ann Preston Invents an Institution
Nothing from the first thirty-seven years of Ann Preston’s life suggests that
she was interested in medicine, let alone that she would become dean of a
medical school. In a letter to her teacher and lifelong friend, Hannah Mo-
naghan Darlington, the twenty-year-old Preston reported some casual botan-
izing,1 but most of her letters concerned political issues and recent literature
rather than amateur scientific pursuits. She was active in the very lively in-
tellectual and political life of Chester County, which was, like the western
New York “burnt over district,” no rural backwater but a center of advanced
thought. The county had not only organized the Farmer’s Library but also a
lyceum visited by well-known speakers, a literary society, and an antislavery
society, for which Preston served as secretary.2 Ann Preston herself wrote
poems, including a commemoration of the burning of the Pennsylvania Hall
by a proslavery mob in 1837 and a published book of children’s poetry,
Cousin Ann’s Stories for Children.3 She was politically active; she probably
wrote for the West Chester Bee, a temperance paper, circulated a petition
against capital punishment, and addressed the West Chester Women’s Rights
Convention, arguing against any arbitrary definition of women’s sphere.4
Benjamin Fussell, a physician and supporter of women’s medical education,
was a near neighbor, and his nephew, Edwin Fussell, also a physician and a
neighbor, married Ann’s friend Rebecca Morris. Preston nursed sick family
and friends; she was deeply affected by her younger sister Lavinia’s death.
In a letter to her friend Lavinia Passmore, she wrote about another young
woman “who appears to be dying with a terrible and loathsome disease”:
“Allas for ‘the ills which flesh is heir to.’ How strong would that spirit be that
has to endure the probations of this world. I gazed upon that poor woman,
and realized that ‘all flesh is grass and the loveliness thereof as the flowers
of the field.’ I felt that beings capable of such intense suffering had the
strongest claims on each other for mutual sympathy and kindness.” 5 It was
not unusual for nineteenth-century American women to draw moral lessons
from their all too frequent encounters with fatal illness. But Preston’s re-
57
Invisible Writing I
sponse enacts her sense of mutual vulnerability and speaks of an ethic of

responsiveness in the face of death, a responsiveness which marks the best
of Preston’s medical writing. Hers was not an attachment to medicine, and
still less an attachment to science; her sense of calling was rooted in the
fragility of the body. One of the projects of Preston’s medical career would
be to animate the institutional genres of regular medicine with this sense.
At the age of thirty-seven, Ann Preston began her medical education. She
was the oldest girl in a family of ten, seven of whom were still alive; her
youngest brother was nearly twenty. Preston had been freed from family
obligations and was occupied with teaching, privately studying physiology
and hygiene in order to lecture on those subjects. After hearing of plans for
the Woman’s Medical College, she decided that it was both right for women
in general to learn medicine and possible for her in particular to do so.6 She
took the Philadelphia physician Nathaniel Moseley, whom she would later
refer to as “a capable modest, and agreeable young man,” as her preceptor,
studying informally in his clinic. When the Woman’s Medical College of
Pennsylvania opened, she enrolled, describing herself as “restful in spirit and
well satisfied that I came.” She dismissed rumors that the college would close
and remarked, “There is a considerable and increasing apparatus and the
Professors seem enthusiastic and to have their hearts in their business.” 7
The college did reopen, and Preston listened to the second round of lec-
tures, wrote her thesis, “A Disquicition on General Diagnosis,” passed her
examination, and received her medical degree with the first graduating class
in 1852. After graduation, she returned to the Woman’s Medical College of
Pennsylvania and heard its round of seven lectures for a third time while
herself giving lectures on physiology to general audiences. Sarah Mapps
Douglass, an inveterate lecture-goer, described one of these lectures in an
undated letter: “I work very hard just now, and recreate by attending Ann
Preston’s lectures. I cannot describe the pure intellect and enjoyment they
give me. How marvelously has God fashioned these poor bodies. How im-
perative the duty that they be used to his glory!” In a subsequent letter, she
wrote, “I like Ann Preston as a teacher of Physiology. I have heard very emi-
nent professors but she excels them all in bringing great truths clearly.” 8 Oth-
ers were less impressed. Anna L. Wharton, in an 1856 letter to her husband,
Joseph, regretted having missed Preston’s free introductory lecture but was
dissatisfied with the subsequent talk:
The audience was choice, very select, mostly Friends, orthodox and Hicksites,
and the room was crouded. There were several pictures of the human body in
different positions hung up, a skeleton and a figure in the middle, or nearly so,
of the platform, covered over with a chintz bag. . . . I liked the lady’s maner and
ease, and was very much interested in what she communicated, but I knew most
of the things she told us about. Indeed there were very few that I had not gath-
58
Invisible Writing I
ered from my own reading and experience. The main subject to day, after giving
the structure of the human body, was “Digestion.” She explained the “modus
operandi” very minutely and satisfactorily but as to the practical end of the busi-
ness, like many another, she had not much to say, and so we came away with just
as much enlightenment on that point as we went. As to food, she told us we
could not depend on general rules, but each one must judge for herself, and
knew better what suited her and what did not than any one could tell, which
thee knows accords with my convictions. The next lecture is to be on the “lungs”
and I hope to gain some knowledge that can be put into practice.9
The decently covered chintz manikin will return to our story; for now, we
should note the continuity between the lectures Preston heard at the medi-
cal college and those she gave to a lay audience interested in questions of
health. Wharton was readier to discount Ann Preston’s opinions than to
change her own. For both writers, decorum was an issue: both Wharton and
Richardson are relieved that the lectures were inoffensive.
Preston’s third year at the Woman’s Medical College would have brought
her in contact with a whole new cadre of teachers. The 1852–53 academic
year was a watershed for the college; physicians suspected (quite rightly) of
irregular tendencies left and were replaced by others whose opinions were
beyond reproach. Preston’s old preceptor, Nathaniel Moseley, sympathetic
to the Eclectic Longshores, was replaced by Seth Pancoast, member of the
Pancoast medical dynasty. Seth, however, strayed from the fold, writing such
works as Blue and Red Light or Light and Its Rays as Medicine . . . How
to Apply the Red and Blue Rays in Curing the Sick and Feeble (1877); An
Original Treatise on the Curability of Consumption by Medical Inhalation
and Adjunct Remedies (1855); Onanism-Spermatorrhea (1858); Porneio-
Kalogynomia-Pathology (1858); and the Ladies’ Medical Guide and Mar-
riage Friend (1859).10 Pancoast only lasted the year, when he was replaced by
Preston’s old neighbor Edwin Fussell. One of the school’s founders, Joseph
Longshore, resigned in March of 1853; Livezey and Harvey followed within
months, and all were replaced by more regular physicians. Finally, Preston
herself was appointed to the chair of Physiology and Medical Institutes and
became the first woman to hold a chair in medicine in the United States.
From that chair, Ann Preston taught until the end of her life in 1873.
While the college was closed during the Civil War, she raised money to found
the Woman’s Hospital, where students could receive practical training. In
1867, she was elected dean of the new college. She is rightly revered in its
official memory as a woman who had devoted her substantial intelligence
and energy to its foundation, ensuring by her own efforts that the medical
education of women would be one of the “revolutions which never go back-
ward.” 11 (See figure 3.) Preston is also an exemplar of one strategy for
nineteenth-century women’s medical writing: cross-dressing or masquerad-
59
Invisible Writing I
Figure 3. Ann Preston, M.D., ca. 1850 (Archives and Special Collections on Women in Medi-
cine, MCP Hahnemann University)
ing. She was scrupulous in the regularity of her medical opinions and argued
that women were as likely as men to become good physicians. Differences
between men and women, in Preston’s view, simply led women to specialize
in such underrated fields as hygiene or to orient their practice to women
patients, so that gender differences benefited the profession as a whole. Like
60
Invisible Writing I
the cross-dressed actor, the woman physician occluded her gender in order
to perform it. Such performances, of course, have their price, as Judith But-
ler recognized:
Identification is always an ambivalent process. Identifying with a gender under
contemporary regimes of power involves identifying with a set of norms that are
and are not realizable, and whose power and status precede the identifications
by which they are insistently approximated. This “being a man” and this “being
a woman” are internally unstable affairs. They are always beset by ambivalence
precisely because there is a cost in every identification, the loss of some other
set of identifications, the forcible approximation of a norm one never chooses, a
norm that chooses us, but which we occupy, reverse, resignify to the extent that
the norm fails to determine us completely.12
In Preston’s case, the project of being “just like” male regular physicians
reached its limit in such crises as the jeering incident when women medical
students who entered the Pennsylvania Hospital amphitheater were publicly
harassed or the Philadelphia County Medical Society’s decision to exclude
women physicians not only from membership but also from consultation. It
is not accidental, perhaps, that those incidents prompted Preston to a more
combative rhetorical strategy.13 But the bulk of her writing was ordinary, the
steady, quotidian production of institutional texts for the Woman’s Medical
College.
ORDINARY INSTITUTIONAL WRITING: WOMEN DOCTORS

AND THE GENDER MASQUERADE
Preston’s was a voice deeply situated in her institution. She was appointed
to committees to write memorial resolutions, to revise the bylaws, and to
write a history of the college.14 She often sat on the committee drafting the
“essay” for the college’s annual announcement.15 She took her turn as intro-
ductory and valedictory speaker, opening and closing the school year.16 Her
lecture “Nursing the Sick and the Training of Nurses” and her letter to the
Philadelphia Medical and Surgical Reporter on the medical education of
women were both printed and used to publicize the college and its associ-
ated hospital.17 After the Woman’s Hospital was established, it was often
Preston who wrote its annual report. Except for the public statements writ-
ten during crises, none of this writing attempts heroic acts of persuasion.
None of it makes, or pretends to make, any contribution to medical knowl-
edge. Much of it was anonymous; Preston did not sign the announcement
essays, and we do not know how much of her work on annual announce-
ments survived editing sessions by the faculty. The history of the college was
not to see the light of day until the seventeenth annual announcement, when
61
Invisible Writing I
Preston had become dean. And one of Ann Preston’s most important texts,
her personal journal, has simply vanished.18
Preston’s institutional location was singular; her adherence to institutional
routine obscures that singularity. Very few nineteenth-century women con-
trolled regular medical establishments, and only the Blackwell sisters had
direct responsibility for both a hospital and a medical school. At an anniver-
sary celebration for the Woman’s Medical College, one of the speakers de-
clared, “Ann Preston was the College; the College was Ann Preston.” 19 Such
a transubstantiation was not easily or commonly available to nineteenth-
century women, who were active in social and political organizations but
seldom in charge of institutions of science or education.20
Ann Preston resolved the central rhetorical problems that faced both the
college and its graduates. She offered a way for the Woman’s Medical Col-
lege to present itself as a pioneering institution and also to insist on its utter
regularity; she devised a strategy for women physicians to assert a profes-
sional credibility while maintaining their conventional gender identification.
Preston acknowledged and represented women’s medical education as an
epochal innovation but steadfastly refused to treat their medical vocation
and training as anything but the natural result of social progress. As an insti-
tutional rhetoric, this stance modulated the Woman’s Medical College of
Pennsylvania’s transformation from a somewhat irregular institution mar-
ginal to medical education into an entirely regular medical school controlled
by women. As a personal rhetorical performance, Preston’s stance offered a
model of dignity, reserve, and courage that is still compelling.
Preston’s first introductory lecture (1855), given a year after she had been
appointed to the faculty, offers convenient examples of her favored rhetorical
tropes. During her first year on the faculty, the college had written bylaws,
purged its remaining irregular faculty, and established procedures for admit-
ting students and examining them on their theses, consolidating itself as a
regular institution. Dean William Johnson, who had guided many of these
changes, suddenly died in December 1854; his place was taken by Harvey,
who would be succeeded by Fussell in September 1856. It was therefore a
somewhat chaotic institution to which Ann Preston welcomed a sixth class—
certainly an institution which had seen conflict and would see more. But to
the newly arrived students, Preston invoked the passage of time as a sure,
secular, and inexorable ally:
The sage poet, not very long since, gravely enunciated the fixed, long sanc-
tioned fact, that
“Just experience shows in every soil,
That those who think should govern those who toil”;
but while the world was complacently humming over the couplet, hard-handed,
clear-headed men went to the ballot box, and through continents ran the electric
62
Invisible Writing I
words—“All men are created equal,” and “governments derive their just powers
from the consent of the governed.” 21
Preston’s understanding of change, even of revolutionary change, is strategic:

change does not come about by argument but through a realignment of
the system. Such an understanding placed a heavy burden on those “hard-
handed, clear-headed” individuals of either gender who undertake innova-
tion, but for Preston, that burden did not include an obligation to argue. As
an advocate for temperance, women’s rights, or abolition, Preston was willing
to work at persuasion. As professor of physiology at the Woman’s Medical
College, she chose to educate women physicians rather than to argue for
their right to medical training. Repeatedly and in many contexts, Preston
maintained that the equity of admitting women to the medical profession is
“beyond controversy”:
You and I feel that “our true sphere is that circle which we are able to fill”;
that it was fixed by God in the capabilities and adaptations of our nature; and
we can well afford to look with quiet pity upon those self-elected arbiters, who,
gratuitously, have taken upon themselves the labor of marking out for us its
boundaries.22
Ladies, we should gain nothing by meeting such as these in argument. Preju-

dices are not amenable to reason. Your business is, not to war with words, but
“to make good” your position “upon the bodies” of your patients by deeds of
healing.23
Despite of opposition, we think it may be truly said, that public sentiment in

this country already decides that woman, in studying the science, and practicing
the art of Medicine, is not stepping outside of her fitting place.24
One would scarcely think, reading these remarks, that crowds of medical
students had gathered to jeer at students from the women’s college who at-
tended clinical lectures or that the Philadelphia County Medical Society was
still decades away from admitting women. One would scarcely think that
Elizabeth Blackwell was sitting idle, waiting for patients, or that Zakrzewska
was arguing with Samuel Gregory about the need for a microscope in the
New England school. Preston’s story of progress was efficacious for its pri-
mary audience, the students and graduates of the Woman’s Medical College.
She regularly offered them an image of their studies as a historical move-
ment rather than as a marginalized fad and of their own role as serious intel-
lectual workers, willing to make good upon the bodies of their patients the
worth of their education. Preston did not offer arguments about their own
gender identity; neither did she demand such arguments from them. Her
caution was as sensible and reserved as her advice that graduates should
continue to sleep, exercise, and enjoy a social life: she wanted these women
63
Invisible Writing I
to live and succeed, and so she constructed a narrative in which their success
was already ensured.
Students of the Woman’s Medical College of Philadelphia wrote theses
that deployed similar narratives to form a place for themselves in a profes-
sion which was anything but welcoming. Preston’s rhetoric had refunctioned
for them the narrative of progress that was a staple of reform discourse, so
that it became a sanctioned epideictic for the new women’s college. Preston
avoided the triumphalism of the college’s founders, who claimed a resound-
ing permanence for the school in its second announcement; she asserted
instead modest but inexorable progress. This narrative offered students two
positions in the story of impending victory: As spectators, they could objec-
tify themselves as agents of universal progress. But, in their daily practice as
physicians, students need only attend to the work before them and, in partic-
ular, remember such “despised things” as prevention, hygiene, and temper-
ance. The higher civilization would advance through their quotidian efforts.
Preston’s strategic refusal to enter controversy and her reliance on a narra-
tive of universal progress place her within the tradition of female speakers
in the abolitionist movement, particularly her close friend Lucretia Coffin
Mott, an active supporter of the Woman’s Medical College of Pennsylvania.
Both women shared a commitment to Hicksite Quakerism, with its decen-
tralized organization and its abolitionist ethics. Lucretia Mott’s extremely ac-
tive rhetorical practice in the antislavery and women’s rights movements, in
fact, was an extension of her Quaker preaching ministry; Hicksites in particu-
lar saw preaching as an intuitive faculty open to women.25 Like Preston, Mott
spoke of women’s rights as an inevitable trend rather than a topic for argu-
ment. In her reply to Richard Henry Dana, who had asserted the importance
of gender differences, Mott declared, “I have not come here with a view
to answering any particular parts of the lecture alluded to, in order to point
out the fallacy of its reasoning.” Instead, adducing scriptural examples, she
concluded:
Let woman go on, not asking as a favor, but claiming as right, the removal of all
the hindrances to her elevation in the scale of being—let her receive encourage-
ment for the proper cultivation of all her powers, so that she may enter profitably
into the active business of life; employing her own hands, in ministering to her
necessities, strengthening her physical being by proper exercise, and observance
of the laws of health.26
In Preston’s 1855 introductory lecture, the argument from progress led,

as it often did for Preston, to an argument from consistency: if women pa-
tients speak of their bodies to male physicians without impropriety, then it is
proper for them to speak about their bodies to women physicians. Preston’s
strategy for framing this argument was characteristically cross-dressed: she
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Invisible Writing I
kidnaped one of her most formidable opponents and spoke through his
voice. Preston quoted a “Professor in one of the most popular medical
schools of this city and country,” who had said that the difficulty of giving
good medical care did not come from any want of medical competence, “but
from the delicacy of the relations existing between the sexes.” 27 This quota-
tion would have been familiar to Preston’s audience; the writer was Charles
Meigs, the creator of the compliant Helen Blanque. In his Woman; Her Dis-
eases and Remedies, Meigs wrote that women’s delicacy was a great obstacle
to effective treatment. While many female complaints could be easily treated
in their early stages, they later became incurable:
All these evils of medical practice spring not, in the main, from any want of
competency in medicines or in medical men, but from the delicacy of the rela-
tions existing between the sexes of which I spoke; and in a good degree also
from want of information among the population in general, as to the import,
meaning, and tendency of disorders, manifested by a certain train of symptoms.28
Preston passed over Meigs’s statement that he had reason to take pride in the
modesty of American women, because “in this country generally, certainly in
many parts of it, there are women who prefer to suffer the extremity of dan-
ger and pain rather than waive those scruples of delicacy which prevent their
maladies from being fully explored.” 29 Nor did she remind her audience that
Meigs was an active opponent of medical education for women. Rather,
Preston dressed her argument in Meigs’s text and made him serve as a sup-
porter of the Woman’s College—as, indeed, his son would in real life. The
argument from consistency had a venerable history in the women’s rights
movement. Susan B. Anthony argued that, if laws written in the generic mas-
culine could be used to tax women, they also permitted women to vote.30
Preston was adroit at embedding the argument from consistency, at in-
flecting it to render ridiculous any argument of biological or spiritual inferi-
ority, at placing it in the mouths of her opponents.
However, Preston’s claim for the propriety of women physicians was rela-
tively moderate. She did not argue, as Harriot Hunt or Samuel Gregory had,
that it was indecent for women to be treated by men or that male physicians
were ordinarily coarse. Preston, in fact, was seldom critical of male physi-
cians, speaking only of “the delicacy of the relations” between the sexes, even
on those rare instances when her considerable satirical gifts were unleashed.
Rather, she freely admitted the shortcomings of both women physicians and
their educational institutions: “We do not deny the fact, ladies, that while
this opposition exists, women cannot possess the advantages in some direc-
tions, which are accessible to their brothers. . . . Nor are we disposed to deny,
that some women may, and do engage in this department, whose abilities
and acquirements do not pre-eminently qualify them to adorn it.” 31 But
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Invisible Writing I
women would not always be denied the clinical advantages open to men, and
the ranks of male physicians offered a “full share” of the underprepared.
Critics of women’s medical education, not male doctors, were dismissed as
“pretentious” or “coarse and ignorant,” eliding the fact that male physicians
were the most vocal opponents of the Woman’s Medical College.
The study of medicine itself, for Preston, became a narrative of progress.
In the 1855 introductory lecture, she addressed the entering class directly,
in the second person, in future tense:
You will pursue the study of Chemistry. . . .

You will study the anatomy of the Human body with its wonderful revelations of
design and adaptation! . . .
You will study the nature of healing and preserving agencies in the Materia Med-
ica and in Hygienic rules. . . .
You will find these subjects points of chrystalization, around which, all the
knowledge that has been gained in other departments of learning and observa-
tion will naturally arrange itself; and the higher the general intelligence and
mental tone of the student, the more beautiful and interesting will become these
special studies.32
Beauty and interest were, for Preston, the signal attractions of medical study.
Here, the academic course forms a narrative of progress: just as society prog-
resses to higher and higher levels of refinement, so the student comes to
finer and finer “points of chrystalization.” The course of study is a persuasive
trope: just as society demonstrates its progressive capacities by accepting
women physicians, the student demonstrates her fine mental tone and high
intelligence by her absorption in her studies.
Preston’s cross-dressed rhetoric consistently refunctioned the tools of the
domestic sphere as the proper apparatus of professional medicine. Preston
spoke of the special talents that the students of the Woman’s Medical College
should bring to their practice of medicine. Not surprisingly, these are of a
virtually domestic character: “We hope for that nice appreciation of the in-
fluence of habits and daily surroundings upon the constitution, which is so
much wanting in medical practice.” 33 Preston recodes such traits as “nice
appreciation” and attention to the everyday as specifically professional quali-
fications. Habits and surroundings influence the constitution and are sources
of health and illness; in attending to them, the woman physician is simply
being a good doctor. Preston translated women’s customary attention to do-
mestic surroundings into the nineteenth-century medical habitus of atten-
tion to the peculiarities of setting, climate, and soil.34 And she interpreted
women’s medical work as an extension of teaching—a profession in which
women had already been accepted—since women doctors could act as “in-
terpreters” of nature’s “secret oracles.” 35
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Invisible Writing I
Preston, inveterate cross-dresser, has sketched out a role for medicine

which would have been associated with feminine domesticity: the doctor is
the manager of daily life, the teacher of good habits. That role is assigned to
the medical profession in general and is also seen as a special contribution
from women and as a replication of the power of (a feminine) nature. Com-
monplaces of midcentury medicine—the laws of health, the importance of
“despised things,” the healing force of nature, the teaching obligation of the
physician—are excavated from the normally masculine rhetoric of the pro-
fession and mined for feminine themes. Preston constructed from these
commonplaces an alternate image of medical practice, in which women were
most radically feminine in their entirely regular performance of a male pro-
fession. Medical domesticity was presented as a professional obligation:
Sound advice is the staple in which the physician should deal, and impressed as
you are with the importance of those “despised things” which here also have
been chosen to confound “the mighty,” and reverencing profoundly the indi-
cations of Nature, you will study to make your practice an enlightened co-
operation with her healing and preserving forces.36
Preston presented herself as a figure of the future success of the college’s

students. She spoke directly to the class:
Ladies, in welcoming you here to-day, let me extend to you the warm hand of
sisterly sympathy. I know the heart of a woman, and especially that of one enter-
ing upon a new and untried course, like that before you.
I know your fears and misgivings. There is much to be mastered; you know
not whether success or failure is before you! But you have entered upon a course
right in itself, and sanctioned by your own hearts, and there is nothing to dread.37
We should not underestimate the significance of this moment: never be-

fore had women medical students been welcomed by a faculty member who
could give them sisterly sympathy. Preston presented herself as an icon of
womanly regularity—in contemporary terms, as a female man. She used her
own subjectivity in aid of an institutional project. Preston ordinarily did not
speak or write personally, in what we now call “her own voice.” As in this
introductory lecture, she offered herself as a sign, a masqueraded sign, that
self-formation as a woman doctor was possible. This was a moment fraught
with dangers for unwomanly self-aggrandizement: Preston claimed the sta-
tus of a responsible intellectual woman, entitled to a position of power and
trust. She performed her own role by foregrounding her uncertainty, mod-
esty, shared hesitation, by remembering her doubt and insecurity. The fact
that she is speaking offers the promise of success; the words she speaks por-
tray her as hesitant and modest.
The rhetoric of Preston’s institutional discourse, of which the 1855 intro-
67
Invisible Writing I
ductory lecture is a fairly typical example, focused on the project of forming

women as subjects capable of medical work. Within that project, science is
morally edifying, and professional labor becomes domestic care. Everything
transgressive or unwomanly about medicine was translated into a feminine
register, so that medical habitus, culturally determined as male, becomes a
performance style of conventional femininity. In unfolding the complexities
of this rhetoric, we might remember Preston’s early understanding of the
claims of suffering. The terrible and loathsome disease she encountered,
mentioned at the beginning of this chapter, might well have been syphilis;
both the patient’s disease and her culturally imposed shame mark her gender
emphatically. Preston experienced this tragic encounter with the gender econ-
omy, however, as a prompt to compassion, not as a special duty of women, but
as an expression of common humanity. Bodies, in this context, appeared not
as male or female but as “beings capable of . . . suffering.” That inflection of
human species being implies a reciprocal claim for “mutual sympathy and
kindness” operating alongside the gender economy but following quite a dif-
ferent logic.38
Preston wanted to educate women physicians animated by such a calling.
The gender masquerade that she modeled for them was strategy for insisting
on their gender regularity while taking up practices normally barred to them.
Since there is no material social position outside gender, only such a doubled
formation, reflecting and confusing gender performance, could accomplish
Preston’s project of responding to human bodies as simply suffering, re-
sponding with a sympathy and kindness that were simply mutual. A subject
formed by such an education would have been most pressingly feminine
while undergoing an exigently masculine training. These tropes and strate-
gies would be repeated in many of Preston’s other published addresses. In
valedictories, Preston assured graduates of the support of the enlightened;
in introductory lectures, she offered them her personal sympathy and help.39
Preston’s public talks defined the institutional rhetoric of the Woman’s
Medical College, both for the initial audience of entering and graduating
classes and for a broader public. Lectures at the beginning and end of the
term were well attended and routinely published. The faculty minutes for
November 15, 1859, for example, note that Preston’s introductory lecture
was heard by “an attentive audience of both sexes.” 40 Commencements of
the Woman’s Medical College could be daunting events: the mayor of Phila-
delphia sent fifty police to the first commencement to ward off threatened
disruptions; in many years, particularly during the war, no public commence-
ment was held. Since speeches of any kind by women to mixed audiences
were by no means commonplace at midcentury, Preston’s bare willingness
to address an audience was a demonstration of the institution’s commitment
to its project.41 She adroitly constructed a professional register homologous
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Invisible Writing I
to that of regular male medicine and modeled for her students a strategy of
discourse and conduct that was both professional and conventionally wom-
anly. Marjorie Garber has asked whether, since “successful treason is not
‘treason’ but ‘governance’ or ‘diplomacy,’ “ it might also be true that “success-
ful cross-dressing, when undertaken as a constant rather than episodic activ-
ity” might no longer be cross-dressing but a different kind of gender perfor-
mance.42 Preston’s institutional rhetoric provided students and faculty at the
Woman’s Medical College with a basic set of tropes and a durable ethos for
the individual rhetorical performances that would be demanded of them.
These rhetorical inventions shape the “essays” published in the annual
announcements of the college. Preston’s first essay, in 1853, makes no men-
tion of the special suitability of women to the healing offices of the bedside
and gives no particular rationale for the college.43 Instead of proclamations,
we read of a lengthening of the term of study, the provision of dispensary
and pharmacy, and the acquisition of new apparatus. Here, the college offers
to make good upon its body its equality with the regular male establishments.
No argument or controversy is engaged; the propriety of the college is as-
sumed, placed beyond controversy.
The sixth annual announcement (1855–56) was to set the pattern used
during the next three years, a crucial and delicate period in the life of the
college. This announcement was sent to a committee that included Preston;
she read the text to the faculty at one meeting, and it was “read, amended
and adopted” when the meeting continued on the next day.44 None of the
early publications of the college received such scrutiny from the whole fac-
ulty, although several of them are quite remarkable documents. The cross-
dressed 1855–56 announcement is marked by the characteristic figures and
arguments of Preston’s rhetoric. Like her public addresses, it makes modest
claims in sober language: the medical education of women is a mark of social
progress, and a particularly feminine medical practice is actually identical to
that of males. The essay surveys changes in the faculty and the student body,
but it also focuses on the economic advantages of medicine as a career for
women: Graduates in practice had been so successful that “it will be long
before the supply can equal the demand.” In fact, women physicians were
doing better than women teachers, since women patients were anxious to
employ them, and many male physicians welcomed them. Those “influential
and eminent” men greeted women doctors “as co-labourers in a field where
there is room and need for both sexes, and in which their interests cannot
be antagonistic.” 45 While Preston had elsewhere explained the hostility of
the medical profession as the reaction of a threatened monopoly, this text
places an assertion of common interest, of a mutually beneficial division of
labor, in the mouths of male physicians—exactly the kidnaping strategy Pres-
ton had used in the 1855 introductory lecture.
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Invisible Writing I
The prosperity of the Woman’s Medical College graduates was given as a

warrant for a proleptic upgrading of the college curriculum, presented here
as evidence of its regularity. The extension of the sessions to five months was
credited to “both . . . [the faculty’s] own sense of duty and . . . the general
sentiment of physicians, as expressed in the resolutions of the National Med-
ical Association.” Women would be trained to a “standard of requirement as
high, and . . . term of study as extended, as those of the best medical schools”;
in fact, the faculty protested licensing the “ignorant and unqualified of either
sex.” 46 The five-month term was said to be modeled on recent developments
at the University of Pennsylvania; the University of Pennsylvania School of
Medicine had extended its term in 1847, before the foundation of the Wom-
an’s Medical College of Pennsylvania. The most recent, striking reorganiza-
tion of the medical curriculum had been that of the Penn Medical University
of Philadelphia, undertaken by Joseph Longshore, an Eclectic. In 1855, the
Penn Medical University established a term that lasted from October
through June and guided a student through a series of twenty-four graded
lectures, extending over sixteen to eighteen months.47 The assertions of recti-
tude of the sixth annual announcement may have been directed toward this
rival; no open controversy, of course, was engaged.
The announcement described, at greater length than the previous essays,
the facilities of the dispensary and clinic, the museum, including its anatomi-
cal, pathological, and materia medica departments, and the chemical labora-
tory. The exclusion of women from hospital instruction was passed over in
silence. But the anatomical laboratory, often described at length in previous
announcements, was barely mentioned.48 Students were assured “unsurpas-
sed” accommodations for boarders, to be secured by the dean before the
student’s arrival. This was an institution so sure of its path that it could be
silent about it. The fact that the Woman’s Medical College was opening new
territory is apparent on every page of the announcement, even in the offer
to secure accommodations in advance so that students need not risk the im-
propriety of staying in a public hotel. The college, however, advertised itself
not in gendered terms but as a progressive, scientific, medical institution. In
establishing a pathological cabinet, the Woman’s Medical College of Penn-
sylvania was marking its aspiration to join the scientific avant-garde; the New
York Hospital, after all, was only in 1855 appointing a paid curator to their
pathological cabinet for “the elucidation of the nature of disease and the
instruction of the medical profession,” and the Pennsylvania Hospital was
still debating establishing a cabinet.49 There is no mention in this announce-
ment, as there had been during the early years of the college, of ladies at-
tending the college for a “finishing education,” or coming to lectures to study
chemistry or physiology as a “liberal art,” or using their medical educations
to treat their families, although the college included such students for many
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Invisible Writing I
years. Instead, students and alumnae are referred to in purely professional

terms, avoiding gender as much as possible: we read of the students, of those
who have graduated in this institution, or the class. Indeed, if it were not for
the title page of the announcement, one might think that the college had
only a general, benevolent interest in the medical education of women.
A similar strategy of cross-dressing marked many of the writings of African
American physicians during the last half of the nineteenth century. The
short-lived Medical and Surgical Observer, founded to improve communica-
tion among graduates of African American medical schools, advertised itself
as providing medical information “from a colored point of view” but did not
mention the race of any of its writers or refer to race in any medical discus-
sions.50 And in Rebecca Crumpler’s Medical Discourses, the first discourse
arrives at its final pages before Crumpler mentions “our women,” “our men,”
and the desire to “raise up children who shall be an honor to that noble race
with which we are identified, in point of strength and longevity.” 51 Once the
race or gender of the divergent physician was identified, the rest of the text
presented a relentlessly normalized surface. That regularity functioned as a
powerful argument for professional credibility.
Rosi Braidotti argues convincingly that Western discourses locate power
in embodied subjects that are necessarily gendered, and she advocates “a
new form of materialism that places emphasis on the embodied and there-
fore sexually differentiated structure of the speaking subject. . . . In feminist
theory one speaks as a woman, although the subject ‘woman’ . . . is not an
essence defined once for all but rather the site of multiple, complex, and
potentially contradictory sets of experience.” 52 Preston’s practice suggests
the paradox that, in the emerging profession of nineteenth-century medi-
cine, one of the most effective strategies for the feminine speaking subject
was to deploy a masculine discourse while paraleptically insisting on her fem-
inine body. She offered these tropes to students, presenting them in the col-
lege annual announcements as impersonal injunctions, phrased in the hy-
gienic discourse of a settled institution. And what an institution the Woman’s
Medical College of Pennsylvania is in these pages—not six embattled and
underpaid faculty members, but a school of unimpeachable regularity, com-
peting with the University of Pennsylvania School of Medicine and avidly
following recommendations of the National Medical Association, a group
that would not admit them as members.
The whole institution was engaged in a gender masquerade, an adroit ver-
sion of the strategy Preston had modeled for students at the college. The
students would be regular physicians; like the most advanced regular physi-
cians, they would develop scientific interests. They had no special qualms
about dissecting, requiring only assurances that the “material for dissection”
would be “abundant.” They would have professional careers, earning good
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Invisible Writing I
money from the open market of women patients. No inflated claims needed
to be made for them; things were stable, would “continue to improve.” 53
It was a reliable performance, one that the college repeated often. The
1859–60 annual announcement, which Preston also helped draft, hews very
close to the mark of 1855. It opens with modest assurances that “the pros-
pects of the Institution are more cheering now than at any previous period
of its history,” marks the formation of the Board of Lady Managers and the
increased demand for “well educated female physicians,” and claims that the
college wants to graduate not many students but a few well-trained physi-
cians—a prudent aspiration, since only one student would receive her di-
ploma in the 1860 class. The lengthening of the term of study, still credited
to the example of the University of Pennsylvania, is pronounced successful,
and the college again affirms its desire to meet standards “in all respects as
high as those of the best medical schools in this country.” We hear again
about the dispensary, the clinic, the museum, the laboratory, the anatomical
laboratory, and the “unsurpassed boarding.” 54 The Woman’s Medical College
of Pennsylvania announced itself as a progressive and scientific institution
that happened to train women, enjoyed broad public support, and followed
conventional models. That rhetoric normalized and contained an experiment
in medical education; only in a few other American cities were women learn-
ing medicine in their own institutions, and in neither Boston, New York, nor
Baltimore was the local medical establishment so unrelentingly hostile as
in Philadelphia.
From the time Preston took up the college’s deanship in 1867 until her
death in 1872, she oversaw the production of announcements in which this
rhetoric was tested. The eighteenth annual announcement, her first as dean,
includes a historical note—perhaps the note she had been commissioned to
write when she entered the faculty. Never again reprinted, the history is a
soberly progressive account of women’s medical education, including a rare
explicit mention of the breach with the Penn Medical University, an admis-
sion of the limitations of the Woman’s Medical College, and a plan to remedy
those limits through new clinical opportunities. The succeeding announce-
ments focus almost entirely on concrete educational and institutional plans:
clinical opportunities, bequests and their dispositions, the new progressive
course, a schedule for laboratory and clinical courses offered in the new
additional spring term. The crises that the institution faced during these
years—rejection by the Philadelphia County Medical Society, the jeering
incident—appear only obliquely, as “difficulties” attending clinical lectures
at Pennsylvania Hospital55 and in an appendix to the eighteenth annual an-
nouncement reprinting the faculty’s response to the jeering incident. An-
nouncement “essays” grew progressively shorter through this period; any
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Invisible Writing I
vestiges of triumphalism were ruthlessly shorn from these pages; Preston’s

rhetoric had become a normalizing discourse for the embattled institution.
HIDING IN PLAIN SIGHT: CROSS-DRESSING

AND GENDER PERFORMANCE
The cross-dressing strategy that Preston devised for her college was one that
she had come by honestly, very early in her life. During her days as an aboli-
tionist, Preston had been connected to activists in the Underground Rail-
road. Her Chester County house was not on its normal route, but one day
(we do not know the year) she was asked to hide an escaped slave. Eliza
Judson told the story, which is worth quoting at length, at Preston’s memorial:
One morning a man came running with the information that the slave-
catchers were in the neighborhood. His house, the point at which the woman
was last concealed, was being searched, and they would be there next. To Miss
Preston’s question as to what she should do, he replied that she must devise her
own expedients, as he could not remain to advise or assist, but must hasten on
and arouse the neighborhood, to assist in the rescue.
Miss Preston was alone, but with great coolness and forethought, she locked
the woman into the closet, went to the pasture, caught a horse, harnessed him
to the carriage, then hastily dressing the woman in her mother’s plain shawl and
Quaker bonnet, carefully adding the two veils often worn by plain Friends when
riding, she started with her in the direction from which the slave-catchers were
expected with the ostensible purpose of attending meeting, it being Sunday
morning.
Soon the slave-hunters came in view, riding rapidly towards them, came close
to the carriage and peered curiously in; but seeing only a young girl and an appar-
ently elderly woman, in the dress of a plain friend, leisurely going to meeting, they
rode rapidly on, to continue their search elsewhere. The great danger was past;
Miss Preston carried the woman to the house which had been recently searched,
where she was comparatively secure. She eventually reached Canada in safety.56
Preston “devised her own expedient” by using the distinctive and somewhat
radical dress of a “plain friend,” a Hicksite Quaker, a group marked by its
insistence on local independence and its antislavery stand; neither she nor
the escaped slave was likely to blend into a crowd. But in Chester County,
plain dress would not have been unusual; placing herself and the woman she
was charged to protect in an eddy of the rhetorical mainstream, Preston
found a way to normalize her exceptional project, just as she sought security
in a house that had recently been searched. Preston’s strategy for evading
the slave-catchers was not to argue with them, but to hide from them by
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Invisible Writing I
provoking their curiosity. Presenting themselves as exotic northern Quakers,

Ann and the fugitive escaped; to their pursuers they seemed strange, but not
dangerous or even interesting.
Preston’s strategy had its costs. Judson, in her memorial, quotes an entry
from Preston’s journal from October 8, 1861:
I have been sad for my country, because it is so slow to learn the wisdom
which would bring prosperity; sad for my disabled mother and desolate home;
sad in the prospects of the Institution to which I have given so much of my time
and my strength, for there now seems no possibility of success; and I fear that,
after all these years of toil, we may be doomed to succumb to the weight of
opposition.57
Preston went on to search for “inward encouragement,” but it is striking to

read here, in a private document, an admission of the very possibility of fail-
ure that her institutional rhetoric excluded. Maintaining two such different
perspectives in the same body, however protected by masquerade, could not
have been easy. Preston was hospitalized for “mania” from September to
December 1862 in the Insane Department of the Pennsylvania Hospital.58
Her friendship with the head of the hospital, Thomas Kirkbride, was held
up to scandal years later, in a pamphlet written during the jeering contro-
versy. And it is only from this pamphlet and from scattered interviews that
we know about Preston’s illness, since none of her preserved correspondence
mentions it.59 Preston gives her most direct account of illness and depen-
dency in her lecture “Nursing the Sick and the Training of Nurses,” given on
May 21, 1863, soon after the end of her hospitalization. The specificity of
her language in this talk suggests a prolonged encounter with suffering but
characteristically translates that experience into professional advice.
Ladies, sick people are like children. They feel what they want without reason-
ing much about it. Let us now, while in comparative health, fortify ourselves by
self-discipline and self-renunciation, all that we may; let the children be trained
to endurance and self-restraint, let home discipline be thorough, and let no weak
tenderness give present gratification at the expense of future suffering; but in
the sweet name of mercy, spare the racked with illness—the smitten of nature—
all your homilies and wise reproofs. The sick bed has its own teachers—teachers
as stern as justice—and needs not our additions; and they who will not try to
humor the little harmless whims and notions of the sick, who indulge in sharp
words and tones and looks, and will protest and argue before they are willing to
stop the rattling of the windows, the grating conversation, or any other dis-
turbing thing . . . may indeed be fitted for some rough work in this work-day
world, but they are surely out of place in that chamber which weakness and
suffering should ever make sacred. “Don’t cross me,” said a sick friend, whose
temper in health was the sweetest, “I can’t bear it”; and they soothed her in her
need, and soon she could bear crosses.60
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Invisible Writing I
Preston might have had more than one feeling about such passivity. She re-
ported her two ideas of perfect physical pleasure: eating quantities of straw-
berries, and “sailing in a little boat, away down, down a smooth stream.”
During her vacation, Preston recorded in her journal that she had had her
fill of both pleasures and found them a vexation to the spirit.61
THE MASQUER UNMASKED: ANN PRESTON

AND THE RHETORIC OF CRISIS
During two great crises of the Woman’s Medical College of Pennsylvania,

Ann Preston publicly took up the controversy over women’s medical educa-
tion. The jeering incident and the 1867 Philadelphia County Medical Society
resolution on women physicians were both turning points in the life of the
college. At these moments, the protective cross-dressing of Preston’s rheto-
ric gave way to what Marjorie Garber calls a “category crisis,” a “failure of
definitional distinction, a borderline that becomes permeable” in a problem-
atic way.62 And at these junctures, Preston’s rhetoric was anything but bland.
Her response to the 1869 jeering incident will be relevant to the last chapter
of this book; I turn now to her letter against the 1867 Philadelphia County
Medical Society resolution on women physicians. The 1867 resolution was a
serious, if temporary, defeat in the college’s long struggle to regularize itself,
a struggle resolved only when the first woman was elected to the society in
1888. In 1858, the society had voted to bar “the faculties and graduates of
female medical colleges” from membership and even to forbid its members
to consult with them.63
Under Preston’s guidance, during seventeen years of unceasing regularity,
the women’s college had quietly courted the Philadelphia medical establish-
ment. Such mild innovations as movement therapy, offered at the hospital
for a single year, were quickly quashed.64 Leading physicians such as Alfred
Stillé, J. Forsyth Meigs, and Henry Hartshorne had been enlisted as con-
sultants to the Woman’s Hospital; S. Weir Mitchell was one of the external
examiners certifying graduates from its nursing school.65 In 1866, Hiram
Corson, who had secured the admission of women doctors to the nearby
Montgomery County Medical Society, asked the state meeting of the Penn-
sylvania County Medical Society to withdraw its endorsement of the 1858
Philadelphia resolution; he was only narrowly defeated. In March 1867,
Preston and Emeline Horton Cleveland joined the president and secretary of
the Woman’s Medical College corporators in appealing for a recision of the
1858 resolution. There was support for recision, however ambivalent, within
the Philadelphia County Medical Society. Seconding the motion, one Dr. But-
ler admitted that, regrettable as it might be that women wanted to become
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Invisible Writing I
physicians, it was clear that they were entering the field, and so they must
be made as competent as possible.66 Just when it seemed that the Philadel-
phia County Medical Society would recognize the women’s college, a circu-
lar from Mark Kerr, professor of materia medica at the Woman’s Medical
College, was shown to the meeting. It was an advertisement for Compound
Asiatic Balm, just the sort of cure-all that the county medical society, and
Preston herself, condemned as quackery and fraud. The society stopped in
its tracks, confirmed the repressive resolution of 1858, and augmented it
with the usual arguments against women doctors: women, debilitated by their
monthly cycles, were unequal to the physical demands of the profession;
the practice of a profession would interfere with the woman doctor’s home
obligations, including that of “giving healthy milk to her infants”; most of all,
women doctors should not consult with male doctors: “Will women gain by
ceasing to blush while discussing, every topic as it comes up, with philosophic
coolness, and man be improved in the delicate reserve, with which he is
accustomed to address women, in the sick room?” Women physicians could
neither treat men nor limit their practice to women, since no family could
tolerate two physicians without “misunderstandings and heartburnings.” 67
Preston’s careful, patient planning had come to naught, torpedoed by a
scandal that took her genuinely by surprise, an unexpected and embarrassing
exposure, a violent disruption of the masquerade of regularity. Preston first
secured Kerr’s resignation and then published “Women as Physicians” in the
Philadelphia Medical and Surgical Reporter (May 4, 1867). It was her most
positive and passionate assertion of her right to a medical career.
The letter begins by renouncing Preston’s favored strategy; now, at last,
she would not avoid a fight: “Although shrinking from all controversy, and
seeking the quiet path of duty, the time has come when fidelity to a great
cause, seems to demand that I should speak for myself, and for the women
with whom I am associated in this movement, and give a reason for the
course we are pursuing.” 68 She then summarized the four main points of the
Philadelphia County Medical Society resolution and answered them in or-
der. To the objection that women are unable to support the work of the
profession, she answered that women had been practicing medicine for a
dozen years without damaging their health. She countered worries about the
“home influence” of women physicians by observing that half the women in
Philadelphia must work, and work hard, for their living; a woman physician
could at least support herself well and run less risk of exhaustion. To fears of
collisions and “heartburnings,” she adduced again the argument from consis-
tency: it was already very common for different members of a family to use
different doctors. The final argument, the argument against indelicacy, re-
ceived a fuller and more careful refutation. Preston’s response was an asser-
tion of reciprocity: women patients were routinely treated by male doctors,
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Invisible Writing I
and it was not uncommon for “some tender experienced mother or elder
friend” to mediate with the doctor for a young woman. If these conversations
were proper, then conversations with women physicians were proper; in fact,
women physicians would shield the “sensibilities of shrinking women.” 69
Neither the Philadelphia County Medical Society resolution nor Preston’s
reply mentioned the Kerr scandal specifically; Preston fought her battle on
the broad grounds of women’s right to practice medicine rather than the
narrow one of regularity. And that broad issue is framed directly, in terms of
calling and obligation, terms that recall Preston’s early encounter with the
mutual human claims of sympathy and help.
When once it is admitted that women have souls, and that they are account-
able to God for the use of the powers which He has given them, then the exer-
cise of their own judgment and conscience in reference to these uses, becomes
a thing which they cannot, rightfully, yield to any human tribunal.
As responsible beings, who must abide by the consequences of our course for
time and eternity, we have decided for ourselves that the study and practice of
medicine are proper, womanly, and adapted to our mental, moral, and physical
constitution.70
This is a remarkable assertion of the emancipatory powers of individual-

ism, coupled with the Quaker doctrine of inner light. Preston claims only to
represent women doctors; she does not offer to speak for women in general.
And she does not exactly argue for the propriety of their course, but argues
only for their right to decide questions of propriety. This focused argument
takes on the whole apparatus of the “separate sphere”: if each woman could,
on reflection, decide what was appropriate to her without consulting any
“human tribunal,” then it would be impossible to enforce the hegemonic
notion that women’s influence, authority, and power began and ended in the
home.71 And both the calling and the accountability Preston claimed for
women are militantly located outside gender. Women are identified as
“souls,” as “responsible beings.” It is as if, on this level of commitment, the
cross-dressed blurring of categories that Preston effected was seen as an ulti-
mate subjective truth: vocation, obligation, the choice of life, all operate out-
side gender. The subject who chooses is a mortal being, not a man or a
woman. Preston justified this subversion by invoking the inviolable authority
of religion: since women are accountable to God alone and must answer for
their choice of profession “for time and for eternity,” they need not answer
to the county medical society. Women facing such terrific sanctions would
not find the censure of regular male physicians so serious; medical educa-
tion, rather than a right granted to them, was their obligation, an exercise of
divinely given powers for which they will be held accountable.
Preston refuted the charge that women physicians were not as well trained
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Invisible Writing I
as men and discussed the final point in the medical society’s resolution: that
no other country than the United States permitted women to practice medi-
cine. Preston pointed out that if women did not enjoy the advantages of a
clinical education, their exclusion had been enforced by the very members
of the county medical society who had refused them entrance to clinics and
hospitals. She deployed the rhetoric of progress, pointing to women who had
traveled to Europe for medical education and to the founding of hospitals
for practical education. And she argued from consistency, pointing out that
there are badly trained men physicians as well as badly trained women physi-
cians. Preston refunctioned the argument that the United States is singu-
lar—always a double-edged sword—by basing the right of women to prac-
tice medicine on the “propriety of republican institutions.” 72
Preston’s final paragraphs invoke the “advancing civilization of the age”
and name the medical education of women as a “revolution which [will]
never go backward.” She asserts that “for us it is the post of restful duty—
the place assigned to us, as we believe, in the order of Providence, and we
can do no other than maintain it.” It seems appropriate to read that us as
editorial; Preston maintains that divine will placed her as first woman dean
of a medical school. She does not fight for herself, she says, but on behalf of
emerging women doctors, and she fights “not because we are ignorant, or
pretentious, or incompetent, or unmindful of the code of medical or Chris-
tian ethics, but because we are women.” The separate sphere argument has
been refunctioned: being a woman is not a reason to renounce medical prac-
tice or to passively submit to the county medical society’s resolution but a
reason to “protest” “against injustice” and to enter public controversy.73
Preston’s reply to the Philadelphia County Medical Society takes up the
ideological materials available to her—ideas of individual obligation, of
progress, of American exceptionalism, of a separate sphere for women—and
transforms them into an argument that recognizes communal responsibility,
suggests an ethic of reciprocity, and dismantles any fixed understanding of
feminine essence. This reply is also in some ways the most personal and
direct of Preston’s surviving works. Preston uses here many of the tropes and
arguments—consistency, reciprocity, progress, republican virtue—she had
developed in the institutional rhetoric of the Woman’s Medical College. In
official documents, Preston offers these tropes paraleptically: she is not going
to argue but is simply going to assert these themes as signs of the undeniable
justice of her cause. In a more public setting, speaking for herself, Preston
deploys the same topics aggressively. But at the end of the letter, instead of
arguing that the Woman’s Medical College should be recognized as a regular
medical college, Preston proclaims that she will struggle for women doctors
“because we are women.” At this category crisis, the masquerade abruptly
ended; Preston’s response was characteristically doubled, since gender was
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Invisible Writing I
irrelevant to the obligations of a “responsible being” and also the avowed

ground of her resistance.
This text produced in a crisis refunctions Preston’s institutional rhetoric.
The Woman’s Medical College of Pennsylvania had steadily divested itself of
any deviation from uncompromising regularity. Its official documents, under
Preston’s guidance, insisted that the college was fostering a medical prac-
tice identical to that of the male profession, but somehow simultaneously
uniquely feminine. When there was nothing to do but to fight, as in this
instance or later in the jeering controversy, Preston made a case with the
materials at hand and transformed those materials in the process. Her orga-
nizational contributions to women’s work in the medical profession were
substantial, but not least among them was the construction of a rhetoric that
allowed women to avoid or enter controversy, to claim and enact their gen-
der or to bracket it, to locate themselves within the medical profession or to
project its progressive transformation. This fluid, combative, achingly anony-
mous and adroitly cross-dressed rhetoric gave women a voice with which to
be doctors, a voice that later women physicians would elaborate, complicate,
and contradict.
79
4
Learning to Write Medicine

Nineteenth-century medical students saw the thesis and its associated exam-
ination as a demanding rite of passage.1 Even though the thesis required
nothing more than a workmanly review of current medical knowledge, it was
still a major task for a student. While Joseph Longshore waited to be exam-
ined on his thesis by the University of Pennsylvania School of Medicine in
1834, he wrote to his brother Thomas that he suffered from “unpleasant
forebodyings, the existing combat between contending mental emotions,
that create sensations, and feelings—to give an expression of which, the pen
of the most sentimental genius would be incompetant.” 2
Joseph Longshore’s trepidation was not unreasonable: the thesis, like con-
temporary gatekeeping performances, would be judged by its grammar and
spelling as much as by its display of disciplinary knowledge. The Regulations
of the Medical Department of the University of Pennsylvania did not pre-
scribe that theses should make a contribution to medical knowledge but only
that they should be on a medical subject; neither did the regulations specify
a level of research.3 But they were quite specific about the mechanics of
presentation:
VIII. The Essay must be in the candidate’s own hand-writing, and must be writ-
ten uniformly on letter paper of the same size, the alternate pages being left
blank.
IX. General bad spelling in a Thesis, or general inattention to the rules of gram-
mar, will preclude a candidate from examination for a degree.4
Nineteenth-century discussions of the role of the thesis in the formation

of new physicians and in the boundary work of the profession suggest it im-
posed special exigencies on a student. The medical lectures that were the
core of nineteenth-century medical education were not, properly speaking,
classes, since students did not recite, answer questions, write papers, or take
examinations. The medical thesis was the first and only time a medical stu-
dent’s writing was evaluated. It was therefore the student’s sole chance to
80
display control of the body of knowledge that had been transmitted in the
lectures and the faculty’s sole chance to monitor the student’s competence
and regularity.
Nineteenth-century physicians, worried about the relatively low standing
of their profession, wanted medical students who were well educated—and,
of course, properly genteel. But since anyone, even an unlicensed physician,
could practice medicine, and since no previous education was required for
admission to medical school, it was impossible to restrict the profession to a
learned elite, although the most powerful physicians continued to be well-
educated members of the middle and upper classes.5 The thesis required
students to approximate, at least, the discursive norms of a learned profes-
sion. Physicians’ worries about the status of their profession often emerged
as worries about the prose style of the thesis. Then as now, a student’s com-
pliance with the rules of “proper English” served as evidence of the correct
class background or, failing that, of a proper disposition toward social norms.
Daniel Drake, writing in 1832, worried that physicians would leave illiter-
ate instructions:
Even at this late period the profession abounds in students and practitioners
who are radically defective in spelling, grammar, etymology, descriptive geog-
raphy, [and] arithmetic. . . . Nothing is more common than to commit gross vio-
lations of [grammar and spelling], in the directions which we write for our pa-
tients; and, what is still more humbling to the pride of the profession, not a few
of us never learn to spell the names, either of the medicines which we administer
or the diseases which we cure.6
Repeatedly, in the nineteenth-century literature on medical education, pro-

fessional control and professional status are connected to literacy: if regular
physicians were to be distinguished from irregular practitioners and quacks,
only those candidates whose literacy was beyond reproach could be admit-
ted. Nonstandard orthography could discredit medical reform, irregular
ideas, or an interest in the medical education of women. When the Bos-
ton Herald wanted to damn Samuel Gregory, founder of the Boston School
for Midwives, Nurses, and Female Physicians—by all accounts a singular
man—they quarreled with his pronunciation, finding him “a poor plagiarist
[who] speaks in a slovenly, monotonous, and halting manner, and cannot pro-
nounce even the commonest English words correctly.” 7 It is in this context
that we should read the medical faculty’s insistence on a thesis in the candi-
date’s “own handwriting” and on conventional spelling and grammar.8
For many physicians, and for most medical schools, literacy implied at
least a taste of latinity. While the requirement that a candidate for medical
school should know Latin was not commonly enforced, and few students
exercised the option of writing their theses in Latin, a failure to write Latin
81
told against a physician, especially if she was a woman. In the 1870 debates
of the Medical Society of the State of Pennsylvania on the recognition of
graduates of the Woman’s Medical College, one Dr. Hamilton supported his
assertion that the faculty of the Woman’s Medical College were generally
incompetent by showing that they were poor Latinists:
. . . notwithstanding the declaration in reference to the high qualifications of this

female medical college, . . . I have not long ago met with two or three prescrip-
tions, written partly in Latin, partly in English, and partly in Latin that I presume
she understood, but no Latin scholar could understand. This was written by a
female practitioner of great celebrity in this city. Now it is only a very short time
since I saw another prescription by one of the female professors; it was in the
same condition.9
While not all physicians unhesitatingly identified good Latin with medical
competence, all agreed that good English, as demonstrated in a hygienically
correct thesis, was essential.
Finally, the thesis was not only a simple demonstration of medical knowl-
edge but also an exercise of the student’s powers of expression. The medical
essay was not clearly distinguished from a belletristic one. At Geneva Col-
lege, theses were judged by “comparative clearness, force, and correctness
of style”; the best was awarded a gold medal. When Andrew Boardman, an
1841 Geneva graduate, felt that his thesis had been unfairly passed over for
this award, he supported his case by quoting a medical professor’s praise
of its stylistic merit. The professor had compared the winning thesis with
Boardman’s, claiming that while the winning thesis had “nothing original, no
striking views or sustained argumentation: the style is verbose, unequal, and
sophomoric, full of scraps of Latin and allusions to heathen mythology,”
Boardman’s was “grave, thoughtful, and argumentative, indicative of an
observant and sagacious mind: the style is clear, forcible, and mature, and
though the positions are bold, they are maintained with courtesy.” 10 Board-
man published his thesis; most medical school regulations permitted such
publication with the permission of the examining professor. And a fair num-
ber of published theses can be found, slim volumes in stiff covers, neglected
in medical archives. Unpublished theses by mid-nineteenth-century medical
students, both men and women, remain filed in folders or bound in groups
in the archives of medical schools. They do not seem ever to have been con-
sulted as a source of information; it is likely that, like a contemporary master’s
degree candidate, the nineteenth-century medical student wrote a thesis
without having read one and expected his own work to remain unread.
As an academic genre, the thesis is oriented to both the past and the fu-
ture. It summarizes the student’s education, serving as a culminating perfor-
82
mance, and it anticipates a future in the profession. In the 1850s, when

women began the formal study of medicine, students wrote theses after a
relentlessly didactic medical training; once they had been examined on the
thesis, they were immediately qualified to practice medicine. Few of the
students writing medical theses would have treated patients in any system-
atic way; very few of them would have enjoyed any clinical training beyond
large hospital lectures in which physicians presented and treated cases. Only
the most elite graduates of the most elite institutions could look toward fur-
ther training as a hospital house officer; others sought clinic or dispensary
appointments, out-of-door appointments to relief institutions, or association
with a professional mentor. The role of physician, for which the thesis was
an audition, was one most students had never attempted.
The most common subjects for theses were diseases, symptoms, treat-
ments, or organs; they are expository and quite general in their content. But
theses could take up a range of medical discourses, from experimental re-
ports to avuncular advice. J. Dickson Bruns’s 1857 University of Pennsylvania
thesis, Life: Its Relations, Animal and Mental, is an essay in natural philos-
ophy, moving from Kant to vitalism, arguing for a hierarchy of the races and
languages according to their powers of abstraction.11 Empirical research also
appeared in theses; Elisha Kane’s Experiments on Kiesteine, with Remarks
on Its Application to the Diagnosis of Pregnancy (1842)12 recounts Kane’s
experiments showing that pregnancy could be diagnosed by a film that
formed on the urine of pregnant women. Both Bruns’s and Kane’s theses
were considered worth publishing; Kane’s was cited by Oliver Wendell
Holmes as “an actual accession to the treasures of science.” 13
Women’s medical schools modeled their graduation requirements strictly
on those of male schools; women medical students wrote theses to demon-
strate medical knowledge, literacy, and belletristic adroitness. The annual
announcement of the Woman’s Medical College of Pennsylvania first men-
tions a thesis in 1852, after one class had already graduated and the irregular
professors had been purged. The regulations stipulate that the candidate, at
the time of application for the degree, must present a thesis written in her
own hand, along with her graduation fee. The thesis was to be, in the familiar
phrase, “upon some medical subject,” and the regulations warn that “general
bad spelling, or inattention to the rules of grammar, in a thesis, will preclude
a candidate from examination for a degree,” criteria copied, almost verbatim,
from those of the University of Pennsylvania.14 The five women in the first
graduating class of the Woman’s Medical College (1851) wrote theses on
topics similar to those produced at the University of Pennsylvania School of
Medicine or the New York College of Physicians; they took up a disease,
injury, or medical practice to display the student’s control of the material
83
presented in lectures or textbooks. Theses were evaluated as much for their

regard for conventions of writing as for their level of medical information.
In 1859, the faculty minutes record such comments as: “spelling not very
good and matter and shape not very clear, but passable,” “very well written
and very good but not original in its thought,” or, from Ann Preston, “a few
errors in spelling and grammar but . . . a very good treatise on the subject.” 15
Subsequent generations of women medical students added to the files of
successful theses; taken together, these texts may well constitute the largest
body of scientific writing produced by women in the nineteenth century.
Women physicians did not publish their theses, although many graduates of
the Woman’s Medical College went on to publish in the alumnae journals of
the school or in the regular medical literature.16 A careful comparative read-
ing of the theses written by male and female medical students has much to
teach us about the ways women physicians wrote the medical discourse that
formed their scientific understanding of the body and about how they them-
selves embodied the habitus of their profession. Later in the century, African
American women entered the medical college; their theses form a cognate
body of early, understudied, scientific texts. I have read the 17 theses pro-
duced by white Woman’s Medical College graduates in 1852–53, transcrib-
ing 10 of them for close study and analysis; a selection of the 161 theses
written by the University of Pennsylvania School of Medicine class of 1851,
closely studying 5 of them; and 4 of the 5 theses written by African American
graduates of the Woman’s Medical College from 1867 to 1888. Taken as a
group, these theses demonstrate a full range of nineteenth-century medical
performances, including varieties of gender performance. For purposes of
rhetorical analysis, I divide the theses in two registers: a discourse of health
and a discourse of medicine; the two registers are distinguished by lexicon,
preferred syntax, overall organization, and presentation of the reader and
the writer. Theses written in the discourse of medicine, the more common
of the two registers, typically concern a disease, an organ, or a course of
treatment and position the student as an apprentice writing to more knowl-
edgeable professors. But, in any class, some students wrote theses addressed
to the public or to patients, offering advice on health. They elaborated an
alternate register—the register of health. The register of medicine is retro-
spective: the thesis demonstrates that the student has done the work set by
his medical school. The register of health is prospective: the thesis looks
forward to the student’s future role as counselor to families.
At the University of Pennsylvania School of Medicine in 1851, 161 stu-
dents graduated; most of their theses concerned a disease, organ, or mode
of therapy. But twenty-four theses concerned issues of general health or
therapies so diffuse as to be modes of hygiene rather than specific medical
treatments (“Water,” “Sunshine”).17
84
THE REGISTER OF HEALTH
Thomas Corson’s “Essay on Health versus Fashion” was based on nineteenth-

century common sense, advising that the reader preserve health by renounc-
ing fashion in matters of diet, exercise, dress, and amusements; it can serve
as a typical example of the register of health as it appeared in the University
of Pennsylvania theses.18 Thomas Corson (1828–79) was a member of an
important medical family; his father practiced medicine in New Hope, Penn-
sylvania, and his relative Hiram Corson would be among the most effective
supporters of medical education for women. After receiving his degree,
Thomas Corson practiced briefly in Jonesville and Morrisville before settling
in Trenton in 1854. He was active in the Medical Society of New Jersey,
serving as its president in 1869; in his presidential address, Physician and
Patient, we hear the hortatory tones he had used nineteen years earlier, in
“Health versus Fashion.” 19 In both texts, Corson took up the role of family
counselor; in his thesis, he moralized, offered concrete advice, ruefully con-
fessed his own addiction to tobacco. This performance, to contemporary
eyes, seems strange; we are not accustomed to the nineteenth-century con-
ventions that prompted a twenty-three-year-old to claim such mature au-
thority.20 For Corson, that decorum seems to have come easily. Some of Cor-
son’s rhetoric was indebted to the lively nineteenth-century literature of
advice, gentility, and good conduct, but he took up an exceptional range of
issues, moving through the whole round of daily life, giving directions that
were both stern and concrete for dress, diet, ventilation, and exercise.
What is absent from Thomas Corson’s thesis is medicine in anything like
the forms we know it today or even those of Kane’s thesis. In “Health versus
Fashion,” the body we encounter is not the finely structured, densely layered
series of tissues of French physiology.21 Still less does Corson present the
segmented body of systems and organs that scientific medicine would render
visible later in the nineteenth century.22 Corson’s lexicon for the body is re-
lentlessly colloquial; he writes of the stomach, the stomach and intestines,
the muscles and muscular systems, the chest, the lungs, the heart, the spine,
the blood, and (quoting from an unnamed source) the pelvic regions and the
lower extremities. Corson’s vocabulary establishes a body which is recogniz-
able, a vernacular body. While contemporary writing in the register of medi-
cine described the body as a series of nested structures, so that organs are
divided into regions and tissues are divided into layers, Corson’s body re-
sembled a schoolroom map: each region is its own state; there are no subdivi-
sions, no fine structures. This is not the body of scientific medicine but the
body as we know it, the body as we might teach it to a young child.
For contemporary text linguists M. A. K. Halliday and J. R. Martin, nomi-
nalization is a central feature of mature scientific prose: an action (food di-
85
gests) becomes an object (digestion), which can be elaborated and modified

(disturbances of digestion, digestive processes).23 In Corson’s thesis, physio-
logical functions become nouns (digestion, respiration), but these nouns are
seldom modified, nor are propositions about them embedded within further
statements. Corson’s digestion never leads to disturbances of digestive func-
tions or remedies for disturbances of digestive function. In mature scientific
writing, such nominal chains allow a text to study and refer to both temporal
processes and concrete objects. Halliday asserts that “the device of nomi-
nalizing, far from being an arbitrary or ritualistic feature, is an essential re-
source for constructing scientific discourse.” 24
Corson’s thesis, on the other hand, is rich in terms for the body as a whole.
He speaks of various life-functions, of the whole frame or the whole physi-
cal frame, of the whole system, organic actions, the human organism, and,
tellingly, of the economy and of ourselves corporeally, terms drawn from
law. In these legal metaphors, health is a unitary state ordered by laws, seen
as undifferentiated codes of prudent behavior. We read of laws of health,
hygienic and physiological laws, sources of hygiene, and laws of hygiene.
Corson’s terms for disease are equally general, including many variations on
morbific (morbific agents, effects, and influences), iterations of the covering
term disease, and common ailments such as dyspepsia, phthisis, pneumonia,
bronchitis, anaemia, gout, and crasis of the blood. The body as represented
in Corson’s thesis is a collection of palpable and evident parts, subject to
diseases that are (or were, to the nineteenth century) immediately given to
the senses.
Corson’s thesis, therefore, exemplifies the broad quietist tradition of early
nineteenth-century medicine. Although there are many ways to tell the story
of how medicine changed in the United States during the nineteenth cen-
tury, one of the most productive is seen in the account given by Charles
Rosenberg in his history of the American hospital, The Care of Strangers.25
For traditional medicine in the early nineteenth century, the body was an
economic system, and disease was an imbalance of input and expenditure.
The body took in air, food, and rest; if these sources of strength were com-
promised, it responded with fevers, inflammations, and swellings. One dis-
ease could turn into another.26 Equilibrium could be reestablished with he-
roic courses of bleeding and purging; by midcentury, doctors had grown
skeptical of these measures and favored the milder systemic treatments Cor-
son advocated: temperance, a moderate diet, exercise, and rest.
Later medical theories, whether based on French clinical medicine or on
German pathology, would resolve the body into much more discrete series
of organs and tissues and construct diseases as we know them today—as
stable entities, each with a unique cause, each to be treated with a preferred
specific therapy. Disease would be represented as a disturbance of an organ
86
or tissue rather than as an economic imbalance. Scientific medicine would

become remarkably successful, and indeed hegemonic, in the last decades
of the nineteenth century, and in all of its inflections, it specified that therapy
should consist of the treatment of identifiable illnesses rather than the adju-
vant support of the patient’s singular “constitution,” which was the norm at
midcentury.27
Thomas Corson’s thesis, with its undifferentiated lexicon for tissues and
organs, its attenuated list of diseases, and its well-developed set of terms for
the economy of the body, could serve as a handlist of terms for traditional
or organicist medicine. But although the register of health was especially
hospitable to quietist systemic therapies such as diet, rest, and exercise, the-
ses in this register could also popularize advances from Parisian clinical med-
icine or offer general information on diseases and their processes, under-
stood in less traditional terms.
Halliday has shown that the early texts in the development of a scientific
discipline are concerned with scientific processes, objects, and relations but
that later texts attend to the act of “doing science.” Early in the history of a
science, texts posit causal relations among events (A happens, so we know
that X happens). A later text draws implications from one event-state to an-
other (happening A is the proof of happening X). As a science develops,
personalized forms (Q said; we did) become more rare. The drift toward
nominalization, paradoxically, leads to syntactic simplification; nominalized
forms do not support complex modifiers. A very common syntactic pattern
for mature scientific prose links a heavily nominalized subject to an equally
nominalized complement by way of a minimal relational verb: “Griffith’s
energy-balance approach to strength and fracture also suggested the impor-
tance of surface chemistry in the mechanical behavior of brittle materials.” 28
This is the sort of sentence that Corson never writes, that is in fact rare in
all the theses in the discourse of health. For Corson, subjects were normally
persons or parts of their bodies; predicates were processes or attributes of
bodies. The text simply presented unmediated objects to the reader, a strat-
egy which complicated the task of a writer who had yet to establish his own
professional authority. Corson argued, for example, that parents tend to ne-
glect their children’s physical education and to favor education over health,
thus laying the foundation for diseases which will afflict the individuals who have
been subjected to such treatment while children, during the whole of their after-
life. For my part, I would rather have a child who at six or seven years of age
should have his muscular system well-developed, and his features darkened by
the rays of the life-giving sun, even though he were hardly able to read his
primer, than have one who at his age had made surprising intellectual advance-
ment, while his skin was as white as chalk; his muscular system hardly strong
enough to carry him, and his whole frame showing that his mind had been devel-
87
oped to the detriment of his body. Leave the mind alone until the body grows
strong, then it will be able to support the effects of strong mental exertion.29
The speaker of this passage offers advice which is not information; no plaus-
ible reader would find these facts and ideas new or surprising. His advice
does not refute any ideas then current about educating children. No poten-
tial reader of this thesis, including the public to which it was addressed but
which would never see it, would argue that it is appropriate to sacrifice
children’s health to their education. Instead of information, the paragraph
offers surveillance presented as care: the physician watches over the child,
shielding him from overly ambitious parents. Corson specified and devel-
oped ideas through personification, the development of an ideal character
who serves an example—the chalk-faced, overstudious child. Much more
complex figures were possible in the middle of the nineteenth century, even
in the register of health; much more complex arguments were constructed,
even in medical school theses.
These straightforward modes of elaboration proved to be very durable for
Corson. Later, addressing the Medical Society of New Jersey as its president,
he again used personification to remind physicians to keep their appoint-
ments with patients: “As the hands on the dial point to the hour when the
visit is expected, the sufferer listens eagerly for the familiar step, which
brings with it comfort and consolation; and if the voice which he so much
desires to hear is not heard until long after it was promised, he grows fretful
and impatient, and his dissatisfaction increases as the leaden hours roll by.” 30
This little drama of illness offers no information not implicit in the first sen-
tence of the paragraph: “If the visit is delayed, the patient becomes irritated
and vexed.” The text advances, not by specifying an argument, qualifying it,
or answering objections, but by establishing the presence of its central terms,
embodying them as generalized persons: the fretful patient, the pale child.
Corson’s speech act in the thesis is utterly at odds with his actual situation as
a student. The speaker of the thesis is constructed as someone who knows
the body and knows social mores; the reader is constructed as the docile
object of instruction, ignorant of the laws of the body. But of course, Corson’s
thesis had as its primary (and perhaps its sole) readers the faculty of the
school of medicine, who were not subject to his instruction.31 The thesis is
Corson’s audition for the role of physician, prompting his reader in the role
of the docile patient.
The role of physician was, of course, gendered at the middle of the nine-
teenth century, but not in any simple way. “Health versus Fashion” partici-
pates in a genre we can trace to Hesiod’s Works and Days: benign patriarchal
advice on the feminine task of ordering the household. But the more mi-
88
nutely Corson’s text takes up questions of domestic and social life, the more
extravagantly it threatens to wander into the domestic sphere.
If low-necked and short-sleeved dresses happen to be à la mode, you will see

young ladies who are threatened with phthisis and to whom it is all-important
that every precaution should be taken to prevent its occurrence, exposing them-
selves, while thus unprotected, to the influence of cold and damp, thus con-
tracting pneumonia, bronchitis and other diseases, which will act as exciting
causes to develope the latent tendency to phthisis which is lurking in their sys-
tem, ready to appear at the slightest bidding.32
Corson goes on to advise “protecting the breast by high-necked dresses

and flannel.”
Corson’s advice is inscribed within the complex nineteenth-century gen-
der politics of tuberculosis, a disease which was frequently fatal and not at
all understood.33 As physician, Corson takes up the position, generally coded
as masculine, of subject-supposed-to-know—a position utterly speculative
for a nineteenth-century physician faced with consumption. One way of con-
trolling that uncertainty was to translate consumption into the domestic
sphere, where approximation and random events were to be expected. But
Corson’s text is also arranged around the ambiguities of a specifically mascu-
line gaze; the young ladies that he warned not to expose themselves are
offered to us in the text, clad in low-necked, short-sleeved dresses; their
breasts unprotected, exposed at once to disease and to the gaze of the reader.
Corson implicated himself in domesticity. He inveighed against specific
ways of dressing; he recommended specific fabrics and styles. Here, as in
the very well-developed discourse of dress reform, a masculine interest in
the “feminine mystery” of fashion is normalized; the doctor speaks of femi-
nine things, but only for the good of women. The closer the speaker comes to
specific domestic practices, the more homely the material that the discourse
handles, the more positive and assertive the performance of masculine au-
thority must be.
There was in the mid-nineteenth century a well-developed, if not espe-
cially prestigious, medical discourse on domestic questions. The Eclectic
Medical Journal of Philadelphia included both domestic and medical recipes
in its “Miscellany” section.34 And physicians writing about the cleanliness of
hospitals, the plausibility of the germ theory, or even the details of surgical
technique might draw upon a feminine domestic register. Samuel Gross, an
extremely important Philadelphia surgeon and a leading critic of women’s
medical education, wrote in his essay “The Factors of Disease and Death
after Injuries, Parturition, and Surgical Operations” that “a blunt, dirty
needle, coarse, unwaxed thread, and rude manipulation, are ill calculated to
89
favor reunion [of the edges of a wound]. A bandage applied unevenly or too
tightly cannot fail to act prejudicially.” 35 Perhaps Gross and Corson insisted
on a particularly stringent patriarchal authority because so often they wrote
like housewives.
The register of health, then, can be characterized by its relatively re-
stricted vocabulary, oriented as much to states and conditions of the body as
to organs, structures, and diseases. The body appears in this discourse as
both a collection of familiar parts and a system organized under economic
laws. The argument of the text proceeds by adding instances and examples,
making present the states of health or disease that have been thematized.
Rhetorically, the text claims a serious and searching authority, generally
coded as masculine, but this authority operates on the undignified terrain of
domestic life, generally coded as feminine. As an ensemble of features, the
register of health articulated a professional habitus that was quite powerful
and would eventually be adapted to the exigencies of the new scientific med-
icine. Many features of the discourse of health—representation of a palpable
body as an economic system, loose organization of information, contradic-
tory gender performance—are common to the theses written by both male
graduates of the University of Pennsylvania School of Medicine and female
graduates of the Woman’s Medical College.36
As we might expect, the register of health, with its attention to issues of
domesticity and its occlusion of professional and scientific practice, was both
attractive to and problematic for the graduates of the Woman’s Medical Col-
lege of Pennsylvania. They had already transgressed conventional notions of
woman’s sphere and were excluded from many professional ties and conven-
tions. And indeed, in the first graduating class (1851), three of the seven
theses were written in the register of health: Anna M. Longshore’s “A Dis-
quisition on Electricity,” Ann Preston’s “A Disquicition on General Diagno-
sis,” and Angenette Hunt’s “A Disquisition on the True Physician.” 37 Ange-
nette Hunt was born Angenette Payne in Ithaca, 1819; she was therefore
thirty-two when she graduated from the Woman’s Medical College. She had
been married since 1837 to Dr. Nelson Hunt, her preceptor. After her gradu-
ation, the family moved to the Verona Mineral Springs House, which they
ran as a water cure resort until the end of the century. Hunt died in 1901.38
Like Corson’s thesis “Health versus Fashion,” Hunt’s “True Physician” is or-
ganized by a very thin vocabulary, oriented toward a material world of health
and bodies rather than a discursive world of medical investigation and dis-
pute. But Hunt’s performance of gender is more complex than Corson’s.
In Hunt’s thesis, specialized medical terms are presented, as it were, in
brackets, as examples of things that ancient physicians did not know: “They
knew nothing of cell germs, or ultimate fibrils,—were ignorant of the circu-
lation of the blood and supposed the arteries to carry nothing but air.” 39 Like
90
Corson, Hunt wrote of an undifferentiated body, of a general economy sub-

ject to mournful catastrophe and generalized disease rather than specific ill-
nesses. The body is not a system of organs and tissues, but man with all his
mysterious relations and connections. Like Corson, Hunt referred often to
general principles of health, such as rules of health, the science of healing,
or more often and more emphatically the art of medicine. Borrowing a con-
vention from opening and closing lectures at medical schools, Hunt invoked
the history of medicine in her opening paragraphs and referred to Hippocra-
tes twice as her authority for recommending that physicians study the theo-
ries of “all the schools.” 40 But for Hunt, history does not end in the triumph
of regular medicine; it establishes a precedent for Eclecticism, the popular
branch of irregular medicine that combined allopathic, homeopathic, and
herbal remedies.41 Hunt’s thesis, like Corson’s, took up the task of correcting
deluded opinion, even when the delusion existed nowhere but in the stu-
dent’s thesis. (A writer in the register of health will energetically argue that
fatal disease ought to be avoided.)
For the most part, Hunt’s thesis concerns groups of physicians and their
customary actions rather than nominalized systems or states of the body.
Like Corson, Hunt speaks of connections among subjects and events rather
than agreements or disagreements among texts and studies. For Hunt, the
“true Physician” is one who “humbly confessing his ignorance . . . looks
hopefully to a higher state of existence, for a fuller and clearer revelation.” 42
Medicine was not, for Hunt, a specialized system of knowledge but a way of
intervening in crises that are as much psychological as physical:
[The physician] often witnesses the darkest tragedies of life & feels his inability
to avert the last mournful catastrophe. Confessions, almost too horrible for be-
lief, are poured into his ear—when the poor victim of circumstance & passion—
weakened by disease feels the weight of his foul secret too terrible for endur-
ance & recognizing a higher & purer nature pours out his soul in confession as
to the supreme being.43
Much of Hunt’s verbal energy is organized in adjectives, often doubled or

written as lists: the science of healing will rise bright in pristine purity and
simplicity, the physician is milde and tolerant. These sentences, like the rest
of Hunt’s thesis, display the complementary pattern of thin lexis and complex
syntax typical of the discourse of health.
Like Corson, Hunt developed and advanced her argument by establishing
presence and giving personified examples. Her initial invocation of the long
history of medicine, however, situates the true physician in both the tradi-
tional past and the imminent future, while the false “counterfeit” physician
is a brief corruption of the present. Transitional phrases, therefore, invoke
the future as a domain of truth and enlightenment: the world is growing
91
wiser; when the profession is purified in the hot fire of public opinion; the
signs of the age which point so decidedly to the education and elevation of
women. Hunt was likely to move from antiquity to the future, and then back
around to the problematic present. Like Preston, Hunt saw progress as a
source of vindication, applying this staple figure of reform rhetoric to sup-
port a transformed medicine.
But the use of irony is Hunt’s most striking innovation in the register of
health and her most interesting gender performance.
The common complaint of many Medical practitioners—that the world is un-
grateful, & they the worst-used men living; causes one to feel that there is a
pressing necessity for medical reform. But opinions differ—& my ideas of this
subject may not accord with the views of those who consider themselves so
dreadfully ill used.
Doubtless, such,—sincerely wish a new enactment which should compel
people to pay them all the respect and attention which their modesty could en-
dure, & in return for pills and plasters, fill their pockets with weighty tokens of
gratitude. But alas! The world is growing wiser, and the fulfillment of their
wishes seems every day less probable: People instead of reverencing their pre-
tensions & taking their infallibility for granted, seem always on the look out for
blunders. If by a slight mistake one of the number administers as much Lauda-
num to a baby, as would be a full dose for a strong man, straight-way a cry is
raised against his knowledge or judgement and his bright prospect of favor &
fortune is clouded.44
Hunt invoked public opinion as the ultimate arbiter of a profession’s util-

ity, associating the cause of women physicians with enlightened democracy.
Against this background, “the common complaint of many Medical prac-
titioners,” is placed as given information, something already known and un-
derstood, as if a twentieth-century writer were referring to an overpaid base-
ball player or to corrupt political campaigns. In fact, while physicians’
organizations did complain about the relatively low status of their profession
and lamented that both the clergy and the law were held in more esteem,
they seldom personalized these complaints, at least in the extensive medical
press. Physicians argued that they ought to be more respected, but they did
not complain of being the worst-used men living. Hunt’s hyperbolic version
of the physician’s complaint transposes it from the sphere of public prob-
lems—the status of the profession—to that of private grievances. The august
body of physicians becomes an overworked, querulous housewife—or even,
by extension, the female invalid—dreadfully ill used.
Such irony is very rare in the theses written by male medical students,
even when their topics—fashionable dress, the evils of the theater—invited
ironic or satirical treatment. And I have never read a thesis in which a male
student directs irony at the profession he aspired to enter, as Hunt does here.
92
For Hunt, irony was a way of establishing the authority required for a writer
of the discourse of health, an authority not easily negotiable for a woman
writer. Just as both male and female physicians struggled to balance their
authority with the voices of patients in the medical interview, young doctors
like Thomas Corson, with whatever trepidation, advised on child rearing and
diet. But Angenette Hunt displaced the language of private, domestic life to
physicians and took up a public, secular voice.
Like Corson’s domestic advice, Hunt’s satire on medicine continues a very
old genre; from Montaigne through Molière, from the dangerous doctors of
Sterne to the terrifying medicine of Dickens, antimedical satires turn on the
physician who does harm to his patient while protesting against his own
treatment. But antimedical satire certainly violates the decorum of the medi-
cal school thesis. Hunt does not mourn with the distraught mother but
laughs at the inept doctor. Hers was a performance of the discourse of health
quite distinct from any at the University of Pennsylvania.
Many women physicians writing in the register of health used irony to
defend their right to speak, ridicule their critics, and contest the emerging
professionalism of medicine. Harriot Hunt, the Boston physician, described
the medical consultation, a highly ritualized event, as a “farce played by doc-
tors.” Hunt parodied a doctor’s explanation of the etiquette of consultation
to an anxious family:
“—no, says the conservative M.D., you desire a consultation; I will bring my
friend, Dr.———; we will have a private interview in your parlor; then he will
see the patient; we will retalk the matter over; then I will give you his opinion!”
Is this not an outrage on common sense and propriety.45
In Ann Preston’s 1858 valedictory address, she speculated that

no lordly Turk, smoking on his ottoman, could better depict the depravation
which public manners would suffer, if Turkish women, should openly walk, side
by side with fathers, husbands, and brothers, to the solemn Mosque, than some
among us have portrayed the perversion our society must undergo if woman
shares with man the office of Physician.46
Women physicians used satire to argue for their own positioned knowl-
edge as a source of medical information. At the end of the century, Rachel
Gleason, an Eclectic water cure physician, dismissed the received medical
opinion that there was no good reason for nausea in the first trimester of
pregnancy: “Certain it is, had these members of the profession vomited for
months, casting up everything but Jonah, until every part was emaciated save
the abdominal region, such preposterous theories would never have been
propounded.” 47
If the medical thesis recalled the conventions of the belletristic essay, An-
93
genette Hunt’s irony shows how far those conventions could be stretched.
And in their public performances of the discourse of health in books of medi-
cal advice or lectures to women on medical topics, women physicians made
irony a central trope. The woman doctor was, to the attending audience or
to her readers, already different from the doctor who normally lectured or
wrote. The very fact of her speaking in public at all, albeit to an audience of
women, was transgressive. But she was also a doctor, an authorized speaker.
Preston usually performed the discourse of health without overt inflection,
in a strategy I have called cross-dressing. Both Angenette Hunt and Hannah
Longshore perform travesties of medical discourse: they seem to comply
with the norms of regular medicine but actually subvert its standing as re-
ceived wisdom. The classical tropes of irony and parody organize Hunt’s per-
formance: the distance between her compliant words and their satiric intent
is patent, available to the reader. Longshore’s travesty, as we shall see, was
unmarked.
For women physicians writing in the register of health, authority was a
vexed issue. Students writing the thesis commonly referred to themselves as
novices; their acute awareness of the examining reader was often expressed
in their texts. But for Hunt, everything in the writing situation was salient,
including the generic masculine pronoun:
I have used the masculine pronoun in describing the Physician but the signs of
the times threaten yet another and more extensive innovation on the ancient
and honorable science than even the irruption of Homeopathy & public opinion
is beginning to prove that there is a female side to this subject, as well as most
others. It is certain that the health of the world, depends on the women of the
world & at least, some of the qualities needed in the medical profession—as
gentleness, patience quick-perceptions natural instinct which is often surer than
science, deep sympathy with suffering—all these belong to the sex in an emi-
nent degree.48
Using the double edge of the argument for gender difference, Angenette
Hunt transformed a potentially embarrassing question—how could a woman
writer describe the true physician without excluding herself?—into an argu-
ment for granting her a medical degree. Hunt demonstrated the need for
women physicians whose competence would be certified by their ability to
argue the need for women physicians. The text, in a starkly material and
institutional fashion, authorizes its writer.
This powerful move is unusual for a thesis specified as inaugural. The
writer asks to join the profession she satirizes; she asks the targets of her
criticism to admit her to their ranks because of the truth of her criticism. In
Angenette Hunt’s case, this strategy probably carried few material risks. Not
only was her preceptor also her husband, but the faculty at the Woman’s
94
Medical College was open to criticism of the established profession. Hunt’s

narrative of medical progress, in which the exclusion of women physicians
was a temporary episode, collocated very strongly with the official rhetoric
of the institution. While Hunt’s advice on health, like Corson’s, was common-
place and (at least for readers interested in homeopathy) uncontroversial,
she performed and demanded from her readers a complex gender align-
ment. She virtually dared her readers to admit her to the profession, but at
the same time, she allied with them against a common enemy and presented
her challenge within an institutionally sanctioned triumphant narrative.
Woman’s Medical College of Pennsylvania theses in the register of health
were likely to construct their readers as astute consumers of medical care
and to advise them in the choice of a physician; male graduates of the Uni-
versity of Pennsylvania constructed their readers as the direct recipients of
hygienic advice. The women’s theses are distinguished by a coolly distant
and critical relation to the regular profession, by their ironic assertion of their
own authority, by their affinity for satire. These are not the global, diffused,
“connected” tonalities we associate with “women’s ways of knowing.” But
given the social situations and rhetorical resources of these early women phy-
sicians, such strategies were both plausible and productive. Hunt transposed
herself chiasmically with the physicians that she ridiculed; they saw women
as querulous patients, but she turned that professional derision aggressively
against them, portraying them as petulant whiners. Satire on medicine, in-
cluding for Hunt an interesting willingness to joke about sick babies, sup-
ported a critique of regular physicians as badly trained and insufficiently
scientific.
Not all the graduates of the Woman’s Medical College who wrote in the
register of health were so audacious, although each of their theses is interest-
ing. Ann Preston’s “Disquicition on General Diagnosis” concerned the per-
sonal qualities of the physician required for accurate diagnosis: the physician
should know the “laws of health” which “regulate the growth of the minutest
hair with as much precision as the laws of gravity balance the starry worlds.”
Preston’s thesis presented the familiar undifferentiated body and thin vocab-
ulary of the discourse of health. Perhaps the strongest commitment of the
thesis is to the act of beginning, of opening, loosely collocated with diagnosis,
the opening move in treatment. We read at the beginnings of the first three
paragraphs: The first duty of a physician; this preliminary step is the founda-
tion; and here, on the threshold of his labors, the wise practitioner. Of course,
it was the writer who had taken up her first duties, essayed a preliminary
step, paused on the threshold of her labors; this act of inception is displaced
into the content of the text.
In her “Disquisition on Electricity,” Anna Longshore-Potts described
electricity as a “subtile fluid” that gathers in currents deep in the earth, issu-
95
ing forth to form crystals and sprout seeds. Too much or too little electricity
would surely cause illness, and we should “defend ourselves by more correct
habits, and further by diet, and still further by the arrangement of our robes,
as to favor a healthful electrical condition.” Longshore-Potts argued that elec-
tricity resembles “volition power”; one can move the point of a compass by
holding it and concentrating on it: “The experiment of the will on the needle
also proves a most intricate and beautiful relation to exist between the voli-
tion power, the living action of the system, and electricity.” Longshore-Potts’s
manuscript breaks off unfinished, but its final paragraph certainly has strong
closural energy:
Electrical currents pass from the equator to the poles charged with a renewed
supply of the forming material gathered from solar light, and heat, which they
retain with them in their passage through the etherial space, from their great
source the sun, and when these currents of electricity pass from the poles up to
the higher regions of the atmosphere, here the effect of what they received from
solar influence is most beautifully displayed in that grand phenomenon aurora
biorialis, on which the ignorant gaze with awe as forbodings of evil to the human
family while the enlightened student 49
There the text ends. The Longshores, as a family, were deeply interested in
electricity, which also figured in Hannah’s thesis, although in less florid fash-
ion than in Anna’s. Longshore-Potts was especially subject to enthusiasms,
even for a Longshore; she would later argue for anticorset leagues that would
bury the discarded corsets of newly converted women.50 At any time, in any
context, she would have been exceptional and perhaps just as weirdly pro-
phetic. But extravagant as her thesis was, it was also a quite regular perfor-
mance of the discourse of health. We find the same attenuated vocabulary
for the organs and tissues of the body, the same attention to the body as a
whole (the living frame), the same thin nominalization (nutritive functions,
curative power, volitional power), and elaborate conversational syntax. The
thesis develops its argument by making assertions about electricity, not by
engaging what others have thought or written about electricity; it associates
the writer with progress and the familiar hope for a new age. Like Angenette
Hunt, Anna Longshore-Potts must manage her own intractable presence in
the text: she did not write about dress or fashion but chose a dignified and
entirely undomestic term, the arrangement of our robes. She undertook a
complex performance of distance from conventional medicine, invoking the
evidence of experiment and authority, positioning herself as the physician of
the future.
Like traditional quietist medicine or noninterventionist sectarian thera-
pies, the register of health was marked by a thin and nonspecific vocabulary
for bodily tissues and organs but a full development of terms for the body as
96
a whole system. Arguments proceed slowly, moving associatively from one

topic to the next rather than gathering force through modifications and elab-
orations of positions; tautologies and synonymous expressions are common.
These texts speak of the body and of its practices, of illness and its treatment,
rather than of physiological opinion or medical practice as a discipline. They
speak in the complex, deeply embedded and elliptic syntax of colloquial talk,
and the speech role that they exact of their writers is never simple. It is a
mature and hortatory role, patriarchal but also domestic; it can be compli-
cated by being placed in a historical narrative or even by satire.
Some elements of the register of health are absolutely common to both
genders; I have not found any difference in vocabulary, nominalization, or
syntactic complexity between theses from the Woman’s Medical College and
those from the University of Pennsylvania. Both speak of bodily events
rather than of scientific controversies. Both develop arguments through tau-
tology and redundancy, illustrating rather than qualifying their statements.
But there are also clear differences associated with gender between these
two groups of texts.
The theses written by women vary considerably in their performance of
the medical persona. Corson approximated the voice of a family counselor,
a guide to the details of domestic life. This voice was one of many available
to male writers of medicine, including those of the scientist, the man of the
world, and the brutal realist. It was particularly adapted to the delivery of
generalized advice to a docile audience, but it was in many ways inappropri-
ate to a male speaker, to a young male speaker, and especially to a young
male speaker whose actual readers were medical experts. Corson, therefore,
had to negotiate a complex gendered performance, an exigency he met with
embarrassed zeal. But Preston, Longshore-Potts, and Hunt established
themselves as speakers for the future, whether that emerging social reality
was embedded in the text, as in Preston’s insistence on beginnings and inau-
gurations, or offered as a justification for the act of writing at all. Hunt and
Longshore-Potts acknowledged the hostility of the profession they were at-
tempting to enter by dividing their potential audience: conventional physi-
cians, hostile to the medical education of women, would be proven wrong,
while enlightened physicians, like the actual readers of the theses, were help-
ing to inaugurate a new age (or to return to a primitive purity of medicine).
The Woman’s Medical College writers positioned themselves outside con-
ventional medicine but argued implicitly that medicine would be reorga-
nized to include them. Both Hunt and Longshore-Potts delivered some-
what transgressive performances: Hunt satirized the medical profession, and
Longshore-Potts may well have exceeded even the broad latitude allowed
irregularity in the early days of the Woman’s Medical College. But both writ-
ers, allied by family ties to the male physicians who served as their preceptors
97
and deft in drawing their audiences into the frame of the theses, passed the
thesis without opposing votes.51
In tracing these differences and similarities between the texts produced
by men and by women medical students, I wonder how much, and in what
way, I am seeing specifically gendered performances. I am thinking here in
Lacan’s terms, of genders as positions available to any subject whatever at
various times, these positions being taken in relation to the whole apparatus
of social role, language, and law.52 Some elements of gender performance in
the theses are patent: the male doctor dispenses advice on good conduct;
the female doctor corrects medical distortions of women’s bodily experience.
These enactments of gender are straightforwardly positional; they depend
on a match between the known sex of the writer and the sex-linked social
role enacted in the text. Such instances of writing as a man or as a woman
illustrate a standpoint theory of gendered medical writing; the writer offers
a vision of the world organized by and through experiences that are linked
to life as a man (the patriarchal chief of the household) or as a woman (sub-
ject to nausea early in pregnancy).53
There are many other ways, of course, in which scientific writing can be
gendered. The discourse on health is contradictory in its gender positioning,
since it enacts a patriarchal authority that is obsessed with a feminine domes-
tic sphere. Feminist scholars of science since Evelyn Fox Keller have also
traced the gender politics of a female nature opened to the gaze of a male
scientist; in later scientific medicine, that gender positioning would become
literal.54 Scientific medicine, at the end of the nineteenth century, would
offer a very wide range of practices, including medical illustrations and
norms of dissection, that literalized the male gaze penetrating the female
body, seen as a series of layers which could be folded back, opened to view,
and analyzed scientifically. Earlier medical traditions, however, had included
practices of visualization and concealment, including the display of wax mod-
els which represented a female body as segmented into sequentially remov-
able organs; flap anatomies sold to middle-class households that offered
paired images of the male and female reproductive organs; or the general
reluctance, in early modern anatomy texts, to represent the female body
at all (except for the reproductive organs).55 Women writers within the dis-
course of health could draw upon this diversified representational economy
to establish for themselves a position as authorized speakers.
Writers of organicist medicine had been trained to see the body as a
mapped system of regions and organs rather than as a series of layered tis-
sues. But for these writers, the body was also a generalized space, a whole
economy, subject to a different style of intervention. Very often, that general-
ized space was represented as a legal system, codified in “laws of health,”
thereby invoking the complex gendering of legal and political space in mid-
98
century United States.56 Law was at once a masculine domain and a territory
contested by women, presented as neutral and impartial and therefore sub-
ject to claims by any speaker. It might have seemed strange for women
in the middle of the nineteenth century to speak of “drawing back the veil
from nature,” 57 although later physicians would normalize that rhetoric. But
women who had agitated against slavery, defied the fugitive slave laws by
working in the Underground Railroad, and campaigned for woman suffrage
would have found it natural to invoke the operation of impersonal laws. Here
is “strong objectivity” with a vengeance;58 just as scientific objectivity can be
a protection against arbitrary gender politics, a kind of legal objectivity was
imputed to nature and claimed by women.59
Finally, the women who wrote theses in the register of health constructed
not only new forms of the medical persona but new organizations of the
medical audience. It was not enough for them to sketch out a way of writing
medicine that they could manage as women; they also had to offer their read-
ers, at this early date uniformly male, a position from which to read their
work. That position intersected, in ways we can never fully reconstruct, with
the quite remarkable domestic space that these writers and their families
must have formed. Over what breakfast tables, in what hilarious evening con-
versations, were these alliances tested and honed? These theses construct a
community of marginality, a historicization of medical discourse, that com-
pensated the faculty and graduates of the Woman’s Medical College of Penn-
sylvania by offering them a narrative of medical and social progress. Their
classmates who chose to write theses in the register of medicine faced differ-
ent exigencies.
THE REGISTER OF MEDICINE
The claim to medical authority was negotiated differently in the register of

medicine. A student writing in the register of medicine could align herself with
medical research and practice that were scientific rather than traditional, or
address a more professional audience. Very often, the same text includes both
traditional and scientific propositions and practices; such transitional forms
were common in midcentury medicine.60 Margaret Richardson’s thesis, “A
Disquisition on Phthisis Pulmonalis” (1852), demonstrates the central fea-
tures of this register, very commonly used in theses from both the University
of Pennsylvania and the Woman’s Medical College of Pennsylvania.61
Richardson’s is the most interesting of the early Woman’s Medical College
of Pennsylvania theses written in the register of medicine; “Phthisis Pulmo-
nalis” can serve as an example of the vocabulary, syntax, arrangement, and
gender performance of the register of medicine. Richardson, born in 1818,
99
was thirty-four when she wrote her thesis. Like Angenette Hunt, then, Rich-
ardson was much older than the average University of Pennsylvania medical
student; she was widowed, well-traveled, the mother of a small boy who
would later take a medical degree from the University of Pennsylvania. And
she was to enjoy a successful medical career that spanned the century; her
obituary described her as the “first and oldest woman physician in Montgom-
ery County” and mentioned a Norristown practice that continued until 1906.62
Richardson’s four-thousand-word thesis is the longest of those produced
by early graduates of the Woman’s Medical College of Pennsylvania. It fol-
lows a conventional format for describing an illness, moving through the
topics of definition, symptoms, causes, prognosis, dissection, and treatment.
This arrangement, common in the University of Pennsylvania theses, was
not used in any of the women’s theses written in 1851 but did organize many
of the 1852 theses. Richardson’s topic, phthisis, roughly corresponded to tu-
berculosis, although Richardson did not understand that disease in the way
that German medicine would later define it. For Richardson, tubercles were
the distinguishing mark of the disease, but they are not prominent in her
text. (The bacillus that causes tuberculosis, of course, would not be discov-
ered for decades, and in 1851 nobody suspected that a germ caused the dis-
ease.) Richardson’s thesis constructs a body distinct from the general eco-
nomic and legal system of the discourse of health, although many of the
treatments she advocated were quite traditionally supportive.
While the register of health was marked by a generalized vocabulary for
tissues and organs, Richardson offers a more fully elaborated set of terms.
When she writes about the lungs and their associated tissues, we find not
only lung, but pulma, pleura, mucous membrane of the bronchia, pulmonary
vessels, and parenchymatous structure of the lungs. Pleura is differentiated
into pleura lining the cavity of the chest and that portion of it encircling the
lungs. The gross structure of the chest is indicated—we read of a narrow
chest—but Richardson also minutely describes tubercles, very minute parti-
cles, scarcely distinguishable by the naked eye, or larger bodies, varying in
size form and color, abscesses of various sizes and secreting a brownish or
blackish pus, and cartilaginous bodies indicating the cicatrization of the ul-
cerous cavities. Richardson writes about lungs rather than using a phrase like
Laennec’s observations of the lungs, but her lungs are more highly differenti-
ated than Corson’s, more finely structured, and susceptible to a more spe-
cific derangement.
As Richardson’s dissection of tubercles demonstrates, disease processes
are also markedly more specific and detailed in the register of medicine than
in the register of health, as if Richardson had been influenced by Parisian
physiology’s search for specific causes of distinct diseases that responded to
standard treatments.63 Richardson’s interest in these issues would not have
100
been fostered by her preceptor, Joseph Longshore, who, like his family, pre-
ferred water treatments, a Grahamite diet favoring whole grains and vege-
tables, homeopathy, total abstention, and electrical and spiritual experiments
over Parisian innovations. Richardson’s detailed and technical interest in dis-
ease processes was by no means universal among American physicians, cau-
tious and selective in their appropriations of French clinical medicine.64
Margaret Richardson’s thesis represented phthisis in ways that a half cen-
tury later, after the adoption of the germ theory, would have been considered
self-contradictory.65 She did not search for a singular or specific cause of the
disease. For her, phthisis was hereditary, although heredity, of course, was
not connected with genetics. A hereditary “disposition” by no means guaran-
teed that any one patient would contract tuberculosis; even an acquired
characteristic could be inherited. Since the contagious nature of tuberculosis
was not understood, heredity functioned as a parsimonious explanation for
its progress through whole families.66 Hereditary denoted not an unavoid-
able disease process but a tendency, something that one would have to
watch, and even something for which one is responsible: “The Scripture dec-
laration that “the sin (disease) of the parent shall be visited upon the children
to the third and fourth generation is more applicable to the present instance
than to any other of which I can form conception” 67 (punctuation as in
manuscript).
But phthisis had many causes besides heredity, including “physical confor-
mation,” specifically a “scrofulous diathesis,” demonstrated by complexion,
body shape, and hair color.68 Richardson is close here to the medicine of
humors, an extremely elastic frame for analyzing the body, and to the enor-
mously influential diagnostic science of physiognomy.69 Such diagnostic
frameworks would have been part of the curriculum at the Woman’s Medical
College of Pennsylvania. Carpenter’s recommended textbook on physiology
emphasizes the importance of “constitution”: “There is no doubt that, in in-
dividuals of the plethoric or ‘sanguineous’ temperament, the proportion of
the whole solid constituents, and especially of the corpuscles, is considerably
greater than in persons of the ‘lymphatic’ temperament.” 70
Richardson also takes into account environmental and occupational causes
of phthisis. Milling, limeburning, and stonecutting could irritate the mucous
membrane of the bronchia and cause a kind of quasi-phthisis, really bron-
chitis, curable “by the various nostrums of the age,” but threatening, if un-
treated, to develop into full-fledged phthisis. Other occupations, “those of a
studious or sedentary kind,” but also “watchmaking, tailouring, weaving &c.,”
compress the lungs, leading to congestion; the circulation of the blood is
suspended “or greatly obstructed,” and the lungs are subject to true phthisis.
Diseases are interchangeable: bronchitis becomes phthisis, unless “cured”
by early treatment before it takes final form.71
101
Richardson’s text deploys both traditional understandings of disease pro-

cesses as bodily imbalances and scientifically advanced understandings of
specific diseases identified through pathological examination of tissues and
lesions.72 In Richardson’s discussion of dissection, she mentions the tu-
bercles: “Postmortem examinations present us with a great variety of appear-
ances of the morbid mass, according to the peculiar character of the disease,
or the advancement it had made at the time of death. But in a truly genuine
pulmonary affection, tubercles, more or less numerous present them-
selves.” 73 But tubercles, however central to the scientific understanding of
phthisis, were useless in diagnosing a live patient. Richardson did not know
of Laennec’s method of diagnosing the progress of tubercles through breath
sounds.74 Her knowledge of the existence of tubercles offered her nothing
to look for or attend to. Indeed, given the absence of any method of imaging
the lungs in the mid-nineteenth century, this mark of the disease would have
been diagnostically useless to Richardson, “until death enables us to obtain
ocular evidence of the facts.” 75
Richardson found a consensus of medical opinion that the “affections ex-
citing the disease,” such as bronchial irritation, could be cured before tu-
bercles had developed, but she records a variety of opinions about its later
course. Some authorities thought that its progress could not even be slowed;
others, that it could remain dormant; still others, that tubercles could be
self-limiting. This difference of opinion had consequences for the physician
trying to shape the story of the disease; as in the medical interview, narra-
tive was central to clinical medicine. In the case of phthisis, there was no
accepted schema, no story that reconciled consumption’s many symptoms
and courses with its infallible (if diagnostically useless) sign—the tubercles.
Richardson, like other writers in the register of medicine, faced the problem
of forming a narrative from that fundamentally intractable material. Her
frustration is palpable:
This [variety of opinions] may arise from the discrepant views entertained by
different authors upon the real nature of the disease the great uncertainty atten-
dant upon its causes and the utter impossibility of knowing positively what par-
ticular structure is involved, or what progress the affection has made, until death
enables us to obtain ocular evidence of the facts.76
As if in response to the shifting symptoms of phthisis, the disease is some-

times a set of symptoms, sometimes a disposition, and sometimes a lesion;
disease is not a stable representation that the doctor can use to think through
a case and its therapy, but a symbolic, thrown-together organization of the
intractable difficulty of the disease.
In her initial discussion of the symptoms of phthisis, Richardson moves
from the domains of physiology and contested medical opinion to present a
102
typical case in its final stages. Her narrative becomes vivid, particular, and
sympathetic:
Diarrhea and colliquative sweats alternate with each other, and great debility
and emaciation ensue—oedema of the lower extremities takes place, the fea-
tures become contracted, the conjunctiva pearly, the hair thin, the nails convex
longitudinally and transversely the roots having sometimes a chalky appear-
ance[,] deglutition difficult, the breathing frequent, the voice whispering, the
cheeks prominent, the eyes sunken and the countenance assumes an altered
expression. During this time the spirits of the patient remain good, and are fre-
quently better than when in health, the faculties of his mind are also sound, in
regard to every thing but his own situation, with the daily increase of debility
and all the symptoms of approaching dissolution, he feels confident of a speady
recovery. Nor can the opinion of his Physician nor the anxious solicitude of those
who feel concerned that he should be aware of his real situation affect a change
in his futile hopes, until the glassy eye and the projected jaw indicate that the
clayey tenement must very shortly become a cold inanimate body.77
Each surface of the body speaks, eloquently, of approaching death, in lan-

guage audible only to the observer; the patient himself is constitutionally
unaware of his peril, his delusion being another symptom of the illness. This
passage is dense with specific information as it is presented first to the anx-
ious physician and then, only when the unmistakable signs of death appear,
to the deluded patient.
Such case studies are not especially common in the medical theses written
in the middle of the nineteenth century. Sometimes, as with this cheerful
phthisic, students wrote generalized narrations in vivid detail, perhaps draw-
ing upon personal experience. (And in the case of tuberculosis, vivid per-
sonal experiences would have been all too common.) Rarely, the writer offers
an illustrative anecdote that connects the scientific investigations of the reg-
ister of medicine to the police functions of the register of health. Kane, for
example, offered as proof of the reliability of his pregnancy test a woman
whom he had transferred to his hospital’s “working ward” on the basis of a
negative test, although she
claimed the privileges of pregnancy in round terms and presented all the other
symptoms of that state in confirmation of her pretensions. She still retains the
suspended catamenia, enlarged abdomen, etc., though five months have elapsed
since the birth of the infant was promised me as a proof of my mistake. Other
cases of attempted imposture, some of them ludicrous enough, which were de-
tected by the same means, I have collected in my table C.78
For the most part, however, medical theses at midcentury, unlike articles in
medical journals, avoided narrative development and did not present case
103
studies. Like other purely academic genres, the thesis diverged from the
discursive forms of its profession.
Richardson’s text, like the theses in the register of health, faced the prob-
lem of positioning both reader and writer within an inhospitable profession.
Unlike writers in the register of health, Richardson summarized medical
opinion on specific topics; her references, like most of those in theses, are
not documented. When opinions clashed, Richardson ingeniously trans-
posed this difference into a rhetorical resource for constructing her own sci-
entific authority: “—of these different views, it is extremely difficult for a
novice in the profession to decide which to adopt—But, in a country like
ours, where liberty of conscience and freedom of thought, is granted to
all, we are not bound to adopt the opinions of our preceptors or wear their
yokes, further than accords with our own judgment, and comports with our
own views.” 79 The very uncertainty of the case, with its multiple authorities
and conflicting information, supports Richardson, the “novice,” in adopting
whatever view she thinks best. Historical and national values—American
freedom of conscience, linked to Enlightenment free thought—sanction her
authority. Such a linkage was coherent with nineteenth-century physicians’
hope to form an “American” medicine and with early women physicians’
view of their entry into the profession as an expression of republican values.80
Richardson’s use of these topics is nicely localized by her equivocating term
preceptors, which is synonymous with teachers and designates her own pre-
ceptor, Joseph Longshore, the probable first reader of her thesis. Like An-
genette Hunt, Richardson portrayed the medical community as divided and
used those divisions to create an authoritative voice for herself.
Other theses from the Woman’s Medical College in the register of medi-
cine offer a range of therapeutic perspectives drawn from scientific medi-
cine, traditional modes of treatment, or Eclectic remedies. Hannah Long-
shore’s thesis carried two titles: the formal title page gives the simple title “A
Disquisition on Neuralgia, its Treatments” and her thesis is listed in college
announcements as “Neuralgia, its Treatments.” But on the first page of the
text, a sort of internal or hidden title reads “Neuralgia: its treatment by wa-
ter.” 81 Other texts, particularly in the first graduating class, offer general dis-
cussions of physiological topics and diseases, referring to the lectures given
in the curriculum. We might include in this group Susanna Ellis’s thesis dis-
cussion of the effects of the nervous system on respiration and digestion and
the thesis on wounds by Phebe Way, which closely follows the account in her
textbook.82 Frances Mitchell’s thesis on chlorosis is, similarly, an elemen-
tary discussion.
Martha Sawin’s thesis on anemia, although very general in its medical con-
tent, offers a striking instance of tacit adoption of standpoint science by an
early woman physician. Sawin asserted that anemia is an underdiagnosed
104
disease of women; her discussion is unwavering in its focus on female physi-

ology. In her discussion of anemia’s causes, Sawin quoted from the analysis
of the constituents of blood by Carpenter, author of the recommended physi-
ology text at the Woman’s Medical College of Pennsylvania: “Carpenters
analysis of the blood in females is this. For 100 parts Water 7.91. Fibrin 2.
Red corpuscles 1.27. Albumen 70. Extractive matter and salts .7 Fatty
matter-6. It may be summed up thus Water 7.91. Solid or coagulable matter
2.9.” 83 Turning to Carpenter, we find substantially the same information, dif-
fering only in details of presentation, presented as a footnote to the text’s
main discussion of the constituents of the blood in males.84 Sawin took au-
thority from the prevalence of the disease in women to use women’s bodies,
women’s experience, and women’s biochemistry as the norm, contradicting
not only Carpenter’s practice but also that of any medical writer she was
likely to have read.85 Conventionally, gender appeared, along with age, diet,
and constitution, as a factor that can vary the proportions of blood constit-
uents: “An appreciable difference exists between the blood of the two Sexes;
that of the male being richer in solid contents, and especially in corpuscles,
than that of the female.” 86 Carpenter did not imply that being a woman was
pathological, but for him the masculine is the theme and the feminine, a
variation. That disjunction is especially powerful within the strong evolution-
ary framework of Carpenter’s Physiology, which began with comparisons of
the extremities and skeletons of humans and orangutans and compared hu-
man blood with that of frogs and “higher animals.” While female physiology
is not sick, it is clearly different; in Carpenter, “different” often means “less
developed.” All of this, Sawin silently sets aside. She does not say why women
are especially subject to anemia or why their blood differs from men’s. She
does not even say that it differs from men’s. Insisting on taking women as a
norm, Sawin’s thesis anticipates the project of a standpoint feminist science.
We do not know much about what happened to many of these members
of the first graduating class. In the next chapter I will discuss Hannah Long-
shore and Anna Longshore (later Anna Longshore-Potts), whose family left
a rich record, but Sawin, Mitchell, and Way are obscure. Gulielma Fell
Alsop, author of the official History of The Woman’s Medical College, Phila-
delphia, Pennsylvania (1850–1950), wrote that Sawin returned to Massachu-
setts and that Phebe Way practiced in Pennsylvania.87 Harriot Hunt men-
tions meeting Sawin and visiting Phebe Way in Baltimore.88 I find no record
of medical practice by Dr. Susanna Ellis or Dr. Frances Mitchell; they may
have practiced in their families or under married names. Except for the rec-
ord of their final exams, none of these students appears in the faculty min-
utes of the Woman’s Medical College, save for a terse note recording that on
November 18, 1850, the faculty passed two motions, that “the Dean have an
interview with Mis Mitchell in regard to Graduating &c,” and also interview
105
her preceptor, Dr. F. X. McCloskey, “in regard to his absence from lectures
&c.” 89 Whatever lay behind these reticent minutes, Mitchell did indeed
graduate without dispute and, according to Alsop, practiced medicine in En-
gland; McCloskey left the Woman’s Medical College faculty in the purge of
irregulars and died in Philadelphia in 1859.90
The members of the second graduating class of the Woman’s Medical Col-
lege of Pennsylvania were less timid in their theses; few of them simply re-
peated their textbooks. Charlotte G. Adams wrote her thesis, a short discus-
sion of nursing, in Latin; like the other theses, hers was routinely passed.
But Hannah Ellis’s, “A Disquisition on Labor,” gave her examiners pause.
When the thesis was first evaluated by the faculty, three of the seven voted
against it. Ellis’s thesis espoused a theory that some of the faculty might have
seen as irregular; she argued that the onset of labor is caused by the ovaries
irritating the uterus and that the normal period of gestation is in fact ten
months. While her preceptor, Joseph Longshore, was a great advocate of
ovarian theories, Ellis based her argument on women’s experiences.91 Like
Sawin, she was an early standpoint theorist. She wrote of “those, often, per-
plexing, and discouraging circumstances of prolonged pregnancies, which,
irregularities are regarded, by the friends of the patient as the results of a
miscount; but which cannot be so readily disposed of by the patient herself;
she has the best right to know whether the fault is in the count or not—.” 92
Longshore moved for a reconsideration of Ellis’s thesis at the next faculty
meeting. The faculty minutes show that she finally received five white balls
and two black and was accepted for graduation, although no preceptor’s
name appears on her title page.93 Within six weeks of her graduation, Joseph
Longshore had resigned from the Woman’s Medical College, forced out in
the early struggle for regularization. Ellis’s essay had no secure institutional
support in those bitter controversies; her insistence on the experience of
the female patient as a source of knowledge and authority is all the more
remarkable.
Henrietta Johnson’s thesis on the skin follows the main lines of Carpenter’s
textbook, analyzing the components of the skin and describing its physiologi-
cal function. Johnson, however, moves from physiology to politics, extending
her topic to an essay on race. Since the causes of skin color are trivial, John-
son argued, there was no medical justification for considering Africans as
substantially different from Europeans. And Johnson used that medical ar-
gument to support criticism of college policies:
Three millions of God’s children are groaning under a worse than Austrian
despotism, because these minute cells are developed in their cuticle. They ex-
clude their possessor from the councils of the nation; they closed the doors of
our scientific institutions and crust the aspirations of a soul, which is no less
106
immortal than its earthly tenement, is not of fairest hue. Minute atoms of a
human being, yet, how powerful their influence on the prejudices of mankind.
A sister asks for a draught, from the crystal fountain of knowledge where we,
are daily supplied, when a conservative mind would deny the boon she craves,
because our heavenly Father has made her of darker hue.94
I have not found any record of the Woman’s Medical College refusing admis-
sion to an African American woman in 1852 or 1853, but Johnson’s thesis
suggests a specific controversy that may not have been recorded. Like An-
genette Hunt, Johnson undertook to criticize the body that would certify her
competence—an audacious and unusual move. Johnson drew her authority
from scientific knowledge; to discriminate on the basis of race is to give
weight to a distinction not supported by medical knowledge of the body.
The construction of medical authority was never a simple matter for a stu-
dent, male or female. Male medical students writing in the register of medi-
cine also faced the tasks of establishing authority, representing the body, and
explaining disease. John Sale’s 1850 thesis, “An Essay on Haemoptysis,” con-
trasts nicely with Margaret Richardson’s discussion of phthisis and allows us
to trace gender differences between men and women students. Hemoptysis
was used especially to denote coughing blood from the lungs, although the
term could denote any spitting of blood. For Richardson, hemoptysis
marked the course of phthisis; it was not an “affection,” a term that denoted
both diseases and conditions produced by diseases, but an event in the body
that could bring on disease or serve as its sign.
Sale, however, discussed hemoptysis as quite simply a disease in itself. He
admitted that phthisis commonly caused it, and phthisis, as we have seen,
was itself an assemblage of conditions. But hemoptysis could also be “vicari-
ous,” caused by suppressed bleeding at some other point in the body. Sale
wondered whether the hemoptysis associated with phthisis is a cause or ef-
fect of the formation of tubercles:
It is not the Hemorrhage that brings on the morbid affection, they are both
the offspring of a previously diseased state of body. The hemorrhage could only
produce the tendency to tubercles, by the depression of system it might induce
from the loss of blood, and the feelings of the patient, though it sometimes pre-
cedes tubercles yet in the majority of cases it is subsequent. It may depend on
the general habit of the body, but its great frequency would lead to the belief
that tubercles was in some manner the exciting cause—acting by producing irri-
tation or congestion of the lung from the space they occupy in its substance.95
Just as Richardson could not use her knowledge of tubercles diagnosti-

cally, Sale could not distinguish whether bleeding from the lungs was a cause
or an effect of the tubercular lesion; in fact, the question did not much inter-
107
est him. Instead, he invoked the “previously diseased state of the body” and
claimed that since hemoptysis was itself a disease, one disease caused an-
other. Sale found in hemoptysis exactly the kind of well-formed narrative
that Richardson, dealing with the whole uncertain and intractable course of
phthisis, was unable to shape. Limiting his discussion to a crisis and brack-
eting the question of its causes, Sale was able to offer a satisfying story in
which clear symptoms prompted the responsive care of the physician. In a
vivid narrative, Sale recounted the onset of hemoptysis, described the blood,
and discussed treatment, specified as “bold and determined.” 96 Sale’s initial
recommendations were uncontroversial, even quietist: the head and chest
should be elevated, clothing loosened, and fresh air supplied in a clean room.
A teaspoonful of salt was then administered. Sale discussed bloodletting, a
logically depletive therapy within organicist medicine, which understood
hemorrhage as the body’s attempt to rid itself of superfluous blood.97 Sale’s
regimen included cups, cold applications, blisters, sedatives, and astringents,
including ergot, turpentine, and opium, leeches to the anus or uterus, and
an easily digestible diet of oysters, boiled eggs, jellies, wine, porter. Moderate
exercise and the avoidance of excitement were recommended. Indeed, such
a course of treatment would provide enough excitement for any one life; it
offered both quietist and heroic interventions in an alternating series. Sale’s
authority for both cautious bleeding and dramatic doses of ergot and turpen-
tine is Dr. Wood, surely the Dr. George B. Wood, distinguished University
of Pennsylvania faculty member, who taught twenty-three “office students”
in 1850,98 and whose lectures Sale would have attended. (Thirteen years
later, Margaret Richardson’s son Thomas would quote Wood with admiration
in his thesis on enteric fever, one of the specialties of his mother’s practice.99 )
In the absence of a controlling or even a consistent theory of disease, Sale’s
thesis offers compelling narrative and a single efficacious invocation of insti-
tutional authority. Not only does he tell a good story; he offers it on good
authority.
S. Wylie Crawford’s “Essay on Hypertrophy and Atrophy” demonstrates
that, even for male medical students, institutional authority could be difficult
to negotiate. Crawford (1827–92) was twenty-three when he wrote his the-
sis.100 The son of the Reverend Dr. Samuel Wylie Crawford, principal of the
Academy of the University of Pennsylvania, Wylie Crawford had received
both a B.A. and an M.A. from the university. Immediately after graduating,
he enlisted in the Army Medical Department, becoming an assistant surgeon
in 1851. He worked on the Pacific Railroad surveys, fought against the Sioux,
and served in Texas and during the Civil War, retiring as brigadier general
in 1873 “for disability on account of a wound.” 101 In acknowledgment of his
industry as a collector of animal specimens, a species of Texas shrew was
108
named after him in 1877. The introductory section of Crawford’s thesis

shows him in the usual medical student’s quandary: what can he write with
any authority?
Destitute entirely of experience, his mind filled with the Theory of Medicine,
the student must, upon contemplation, feel his deficiency, as regards practical
observation or experience. In surveying the wide field over which he has just
passed, he feels he can add no new gems to ground enriched with the experience
of years; or add new luster to those already there. He is to pursue a beaten tract,
to follow, not to lead, and to place his confidence implicitly in those pioneers
who have preceded him, till research, or experience, have testified to the cor-
rectness of their views, or convinced him of their errors. As a medium course
we have chosen the field of Pathology, as the more fitting province for the specu-
lations of the tyro in Medicine, and among all the varied and interesting subjects
which it unfolds to us, none have appeared to us more important than those
disorders attendant upon the great Physiological process of Nutrition.102
This “tyro” economically summarized the choices available to him as a writer:

he could write a thesis in the register of health, “one bearing upon the Prac-
tice of the profession,” but with little hope of adding to the gems of thera-
peutic knowledge, since such knowledge was seen as almost exclusively the
product of experience. The field of practice was too full, but his field was so
empty. Crawford therefore located himself as a willing apprentice who dif-
fered from his preceptors only when time and experience convinced him
that they were in error. Of course, the same rule also rendered his agreement
provisional and temporary; Crawford affirmed confidence in his preceptors
but made no promises for the future. Crawford translated his position at the
threshold of the institution into a rhetorical resource; he is the credible neo-
phyte whose speculations are entirely based on his institutional membership.
University of Pennsylvania students had other strategies for constructing
medical authority. When dealing with a disease that utterly resisted treat-
ment, like diabetes, the apprentice doctor could declare that the physician
faced unalterable limits: “Of the many processes going on within the living
body he knows little & he can only speculate concerning them. Of the prin-
ciple of life he knows nothing & it is probable that the secret springs which
give vitality to the organized being will be forever hidden from him.” 103 Or
the writer could establish his membership in the profession through a display
of technical knowledge. Jesse Rivins’s thesis, “An Essay on Auscultation in
the Diagnosis of Pulmonary Disease,” described minute variations in sounds
audible only to the physician and only when the physician had drawn all his
attention to the sounds. Phrases such as analogous to the sound of throwing
salt on burning coals articulate experiences available only to physicians and
109
establish Rivins’s membership in the profession.104 The thesis does not pre-
sent new information but argues, through precise description, that the writer
experienced the same things as the reader and so belonged in the reader’s
professional community.
The relation of the student to the medical community differed markedly
between the University of Pennsylvania and the Woman’s Medical College
of Pennsylvania. Both male and female doctors writing in the register of
medicine described the tissues and organs of the body quite precisely; both
of them gave accounts of diagnostic tests, chemical and pathological. Both
male and female students negotiated the differences between scientific med-
icine and organicist medicine, often borrowing liberally from both schools.
They both oriented their theses toward therapy and constructed authority
from the therapeutic interventions they prescribed. Both male and female
students, not surprisingly, quoted from the lectures they were given and
spoke modestly of their own experience. But for male medical students,
however marginal or avant-garde the content of the thesis, the relation be-
tween the profession of medicine and their own education is transparent.
Women students were skeptical of medicine, and medicine was hostile to
them. Some women solved this difficulty by historicizing themselves, seeing
themselves as new women physicians. Others invoked the faculty of the
Woman’s Medical College as the true core of the healing profession. But the
unbroken chain of sponsorship—from student to medical school to medical
profession—that supported the writing of University of Pennsylvania stu-
dents was never as strong for Woman’s Medical College of Pennsylvania
graduates. For male graduates, that chain was unproblematic and therefore
flexible. The authority of teachers sutured gaps in students’ medical dis-
course or supported positions considered controversial within the profes-
sion. Given the marginality of the institution, the Woman’s Medical College
could not support its graduates in medically innovative or risky positions,
although its connection to reform movements offered an alternate resource
to students writing in the register of health. Students writing in the register
of medicine repeated the information presented in their lectures, as Phebe
Way did in her thesis on wounds, producing relatively conventional writing.
Students who made innovations in medical discourse, like Martha Sawin or
Hannah Ellis, with their woman-centered discussions of anemia and labor,
did so tacitly, without argument.
Women students also, as a group, wrote shorter theses in the registers of
both health and medicine. Of the eleven theses in the register of medicine
written in the first two graduating classes of the Woman’s Medical College,
four are under fifteen pages long; except for Margaret Richardson’s, none is
over twenty-nine pages. A group of fourteen theses from the University of
110
Pennsylvania graduating class of 1850 shows two theses under fifteen pages
and four over twenty-five, although fifteen to twenty pages is the most com-
mon length at both institutions. In student writing, length is never inconse-
quential. While this difference does not speak to distinct medical or social
orientations, it may indicate that the women graduates were less comfortable
in composition and that they were inventing the forms of their texts while
they produced them. A second difference between theses produced at the
two institutions is also brutally material: corrections and additions in another
hand are much more common in the theses produced by women. In the
etymological discussion that introduces almost all theses on diseases, the
Greek words are painstakingly penned in another hand at the Woman’s Med-
ical College but never at the University of Pennsylvania. Many students had
spelling problems, improvising both common and technical terms; both men
and women varied in their use of conventional punctuation. Many a thesis
from both of these institutions handles transitions with a dashing “&c.” But
corrections are very seldom penciled into the theses written at the University
of Pennsylvania; they were very common at the Woman’s Medical College,
especially in the first class. Frances Mitchell’s thesis, in particular, is heavily
marked, with punctuation added in almost every sentence. And, to our eyes,
the changes are not always for the better. To no particular advantage, Mc-
Closkey changes condition to situation and assumes to resumes, demonstra-
ting that the urge to tamper with students’ prose is among the strongest of
pedagogical impulses. (See figure 4.) It may be that, with a relatively small
class, the faculty was willing to undertake the labor of marking up these pa-
pers. And it may also be that the writing of women was assumed to be less
correct, more in need of amendment.
The thesis was, for almost all students, a problematic performance. For a
woman who, unlike her male counterpart, wrote the thesis after half a life-
time of experience, including the usual labors of nursing family members,
such an apprentice’s document must have been even more contradictory.
The Woman’s Medical College of Pennsylvania, the institution that might
have supported that labor, was itself marginal and reflected the insecurity of
its students. Whether the women graduates were writing conventional theses
or being innovative, they had to construct the authority for their discourse
from found materials. Their solutions were often unorthodox; we read in
these theses forms that are very unusual for academic writing, including sat-
ire and critique. We also see an unusual willingness to cite lay opinion, partic-
ularly the opinion of women, and sometimes an unwillingness to accept the
male body as a physiological norm. For African American women physicians
writing later in the century, both the problem of establishing their authority
and the institutional resources supporting them had ramified.
111
Figure 4. Frances G. Mitchell, thesis (1851), page 20, showing corrections probably made by
her preceptor, Francis X. McCloskey (Archives and Special Collections on Women in Medicine,
MCP Hahnemann University)
AFRICAN AMERICAN WOMEN PHYSICIANS

AND MEDICAL AUTHORITY
African American graduates of the Woman’s Medical College entered a more

prestigious institution than that of the graduates of the 1850s: seven of the
twelve known nineteenth-century African American graduates dated from
the 1890s, when the women’s college was an established institution; its grad-
uates were admitted to the Philadelphia County Medical Society; and its
students had access to the medical institutions of the city. Earlier graduates,
beginning with Rebecca Cole (1867), were often members of the established
African American middle class of Philadelphia; they brought to their medical
study the prestige of broadly recognized political and educational connec-
tions. Taken as a group, however, nineteenth-century African American
graduates of the Woman’s Medical College demonstrated a dizzying range
of experiences and medical interests.
Consider for example the contrasting careers of Caroline Still Wiley An-
derson (1848–1919) and Eliza Grier (18??–1902). (See figures 5 and 6.)
Anderson graduated in 1878; she was the daughter of the prominent Phila-
delphia abolitionist William Still, had been educated in local Quaker institu-
tions, and graduated from Oberlin in 1868. Although she responded to a
later Oberlin alumnae survey by saying that she had no academic degrees, as
a college graduate, she would have been among the best-educated Woman’s
Medical College students.105 Before entering the women’s college, she taught
for a year at Howard University and entered the medical school there, study-
ing with Isabel Barrows, 1868 graduate of the Woman’s Medical College of
the New York Infirmary and specialist in ophthalmology. Anderson wrote
her own thesis on fibromata.106 She married the prominent minister Matthew
Anderson and with him managed the extensive activities of the Berean Pres-
byterian Church. She ran the Berean Dispensary, which offered medical
care to Philadelphia’s African American community, was vice-principal of the
Berean Manual Training and Industrial School, where she also taught elocu-
tion, physiology, and hygiene, and she managed the Berean Cottage at the
seashore, “a place of rest for the hard working and honest toilers of the
race.” 107 She founded a YMCA for African Americans and was active in
the Woman’s Christian Temperance Union.108 Anderson helped build the
Berean school into an important Philadelphia institution, one that offered
the African American community job training, an education for public life,
and diverse cultural opportunities. And she maintained both an active medi-
cal practice and her scientific interests, giving a talk, “Popliteal Aneurism,”
to the Woman’s Medical College of Pennsylvania Alumnae Association in
1888.109 Her death was mourned throughout the city.
Eliza Grier’s 1898 graduation from the Woman’s Medical College was
113
Figure 5. Caroline Still Wiley Anderson, 1868 (Oberlin College Archives)
Figure 6. Eliza Grier, from her 1898 class picture (Archives and Special Collections on Women
in Medicine, MCP Hahnemann University)
greeted with an article in the North American Medical Review entitled “Coal
Black Woman Doctor,” which gives her first name as “Clizo.” 110 Dean Ruth
Lathrop wrote a reference for the new graduate, describing her as having
“‘respectable standing’ as a student of medicine; how much better work she
would have done had she not been constantly harassed by want of adequate
means of support it is difficult to say.” 111 And it does not seem as if that
question was ever answered. Grier, who described herself as an emancipated
slave, studied at Fisk University from 1884 to 1891, taught at Payne Normal
School in Augusta for a year, and came to the women’s college in 1893. One
account describes her going south to pick cotton after a year of school.112 She
practiced in Greenville, South Carolina. In a letter to Susan B. Anthony,
she described herself as having “a pretty good practice, but mostly among
the very poor and in neglected districts,” and explained that illness had ex-
hausted her resources: “There are a great many forces operating against the
success of a Negro in business. These, however, I hope someday will be over-
come. The only thing that impedes my progress is that I am trying hard to
carry on my art and am illy prepared, in a financial way to continue when
hardship and want come on.” She asked for help, invoking “the blessed Mas-
ter” to ask for Anthony’s aid.113 Anthony was sympathetic but declared herself
unable to help, forwarding the letter to the dean of the Woman’s Medical
College. A year later, on April 14, 1902, Grier was dead.
While white students at the Woman’s Medical College came from a variety
of family backgrounds and entered the college with a range of life experi-
ences, it would be difficult to find among them circumstances so starkly con-
trasting. And the complexities of the sisterhood offered to African American
women by the college are illustrated by the experience of Sarah Marinda
Loguen, an 1876 Syracuse graduate who came to the Woman’s Hospital for
her internship. The clinic superintendent was struck by Loguen’s resem-
blance to one Dr. Loughune, a white woman from Nashville, Tennessee, com-
menting, “Thee might be twin sisters.” A hasty consultation determined that
the two women were related, and Dr. Loughune resigned her internship.114
Caroline Wiley Anderson’s “Thesis on Fibromata” demonstrates how Afri-
can American women physicians negotiated these complex relationships.
“Fibromata” is an extensive and assured work; this thesis by the former presi-
dent of the Oberlin Ladies’ Literary Society ran to forty-five orthographically
irreproachable pages. Unlike the vast majority of theses by either male or
female students, Anderson’s argued a point, that the “extirpation of said tu-
mors has been proved a necessity by the results, and the successful perfor-
mance thereof entitles surgical operations upon such growths to greater fa-
vor, and consideration.” 115 And, for Anderson, that point was located within
an ongoing medical conversation about what caused fibromata, their effect
on health, and their efficacious treatment. Her opening page reported:
116
“Some suppose tumors generally to be due to an accidental, local irritation,

and limited to certain parts of the system, among the supporters of this view
are Virchow, Fleisch and O. Weber.” But she tempered this avant-garde posi-
tion with an acknowledgment that “there are largely inherited tendencies
and innate predisposition to the development of such growths,” as shown by
“clinical experience, and the views of able writers.” 116 Anderson quotes freely
from able writers in the pages that follow, discussing the nomenclature of
the tumors, the history of their investigations, and their appearance under
a microscope. She reported three pages of controversy about the correct
name for such growths, concluding, “In these cases there seems no reason
why both prefix, and affix might not be retained thus: myo-fibro-cartilaginous
etc., and an important portion of the structure thus kept prominent.” 117 An-
derson, fully conversant with the literature, felt confident to intervene in an
ongoing dispute. Writing twenty-seven years after Angenette Hunt, Caroline
Anderson had become fluent in a medical discourse that combined the regis-
ters of health and of medicine seamlessly, if not consistently.
The thesis continues through the usual topics of appearance, location, dif-
ferential diagnosis, treatment, and dissection. She records approvingly en-
tirely traditional quietist treatments, like that of Dr. Warren, who prescribed
eighteen months of “confinement, and solitude, and strict compliance with
his orders” to a young man who developed a tumor from overexertion.118 The
last fifteen pages of the thesis summarize an article by “Dr. Atlee” on the
surgical treatment of fibroids; Anderson’s citation of the article is distinctive
in giving it a date and a place of publication: 1876, at the International Medi-
cal Congress. Atlee’s article repeats the main categories of the thesis—classi-
fication, location, and treatment. But his focus is on surgery, particularly he-
roic surgery, even when the surgeon is mistaken:
In another case, “a rough, irregular, tumor-like mass presented in the vagina

upon what seemed an inverted uterus,” it was removed and found to be the
body of the uterus. Whereupon the following query suggested itself to Dr. A,
“though an error of diagnosis, will not the amputation of the body or entire
removal of such a diseased organ be the best mode of treatment, keeping in
view the comfort, and life of the patient”? We can conceive of circumstances
which would seem to warrant even such heroic treatment as this, suggested and
favored by Dr. A.119
Anderson aligns herself with a surgical, if not a medical, avant-garde. And

her experience as a medical student supported that identification. Anderson
describes two surgeries that she herself witnessed: the removal of a fibroid
tumor from the breast, and the removal of a fibroid from a forearm, both at
the Woman’s Hospital.120 Anderson gives detailed accounts of both surgeries,
including the operative procedures, closing sutures, and subsequent man-
117
agement of the patients. The more developed facilities of the Woman’s Med-
ical College allowed Anderson to claim the authority of direct knowledge, to
establish her own “clinical experience,” that talisman of traditional medicine,
while advocating advanced modes of treatment.
But the college could not offer Anderson any credible answer to the ques-
tion of how fibromata were related to race. “One of the usually admitted
predisposing causes of fibroids is Race, the African being peculiarly liable it
is said, but no statistics at our command throw any light upon this subject,
nor are any reasons offered to account for this statement.” 121 Anderson was
not the only African American graduate plagued by a lack of information
about race and health. Halle Tanner Johnson, acting as infirmarian at the
Tuskegee Institute, described six phthisic patients in a letter to the Woman’s
Medical College Alumnae Association: “I have had no experience worth
speaking of, and, therefore, am somewhat timid about expressing myself;
but I would simply say that I am exceedingly interested in this question [of
treatment for phthisis] and would like to get all the important information
upon the subject that I possibly can, as I regard it as an important race ques-
tion.” 122 Tanner’s frustration is clear: nothing in her education explains why
this illness appeared so frequently in “very black persons,” 123 and she could
not see how that question would be answered if not by her own work, the
work of a very young graduate. Like Anderson, Tanner felt authorized to
intervene in a scientific debate; like Anderson, she realized that nothing in
her education was a reliable support when that debate turned to “an impor-
tant race question.”
A very different set of constraints motivated the work of Georgiana Young,
whose thesis on opium was written in the same year as Caroline Wiley An-
derson’s.124 Georgiana Young, in the words of her grand-nephew, “did not
divulge her race while a student” at the women’s college.125 And there is, in
fact, no mention of her race in her student records, in the account of her
graduation, or in the subsequent records of the alumnae association. Young’s
thesis is equally disguised; it offers a thoroughgoing performance of cross-
dressing. Young presents opium as a source of excitement, an exotic Asian
artifact, and a terrifying blight. Although the thesis concludes that opium
“may be the source by its judicious employment of more happiness, and by
its abuse of more misery, then any other drug employed by mankind,” it is
much more vivid in its pictures of opium-induced happiness than in its warn-
ing against opium abuse.126 After describing the manufacture of opium and
specifying chemical tests for its presence, Young offers the following account
of its operation: “It increases the force and frequency of the pulse, augments
the temperature of the skin, invigorates the muscular system, animates the
spirits. It intensifies all the capacities for thought and gives new energy to
the intellectual faculties. . . . a delightful placidity of mind succeeds, insen-
118
sible to painful impressions, forgetting all sources of care and anxiety.” 127 A
considerably less compelling account of the bad effects of large doses of
opium follows. In describing how opium is taken in the “flowery kingdom”
of China, Young becomes lyrical:
In the mansions of the rich, there is usually found fitted up for the accommoda-
tion of friends, a private boudoir, richly ceiled and garnished with superb adorn-
ments, such as only art can achieve, and wealth procure, and here rich paintings,
with choice scraps from Confucius adorn the walls, and carvings in ivory, with
other articles of vertu grace the tables. Here also is provided in chief, the gilded
Opium-pipe, with all its appurtences and there host and guests unrestrained by
curious eyes, deliver themselves up without concern to the inebriating Chandoo
and its beautific transports.128
Meigs would have been proud of this interior. Young is certainly presenting
the smoking of opium (as against its administration in other forms) as a de-
generate oriental practice, but she has made that practice luxurious, artistic,
enticing. A page later, she offers an account of the Chinese adoption of the
“vice” of opium as if she were beginning a new topic. And indeed, Young
simply wrote two stories of opium: one in which it was a source of pleasure,
indeed happiness; another in which it was a vice to be avoided. It is the first
story that controls the thesis; the second offers a cross-dressed disguise.
Juan Bennett’s “Sanitary Chemistry” (1888) took up the topics of public
health that had been associated with African American women physicians
since Rebecca Cole’s service as a sanitary visitor in 1868, but it refunctioned
them in light of the chemistry Bennett had learned at the women’s college.129
“Sanitary Chemistry” was organized by the traditional issues of air, water,
and food, but it treated them as chemical questions. It detailed tests for the
adulteration of sugar, tea, vinegar, and milk, and ways of measuring the
contamination of water and air. Bennett thereby transformed the sanitary
worker from a teacher who would offer instruction to an authority who could
constrain action. Elizabeth Blackwell had praised Rebecca Cole for her tact
and care in giving “simple, practical instruction to poor mothers.” 130 But Ben-
nett saw herself as joining the “sanitary authorities,” monitoring the quality
of air and water to prevent epidemics. Their authority would be broad: “The
public control in the public interest, must extend to the sanitary condition
of every household, not among the poor alone, at least equally among the
rich.” 131 Every house, every source of water, would fall under their supervi-
sion: “During epidemics it is best to condemn all waters containing more
than .015 gram of chlorine per litre.” 132 But the sanitary chemist retained
the moral authority of the sanitary visitor, the medical warrant for judging
customs and habits according to the laws of health: “A depraved taste has
led to the demand for bright green pickles.” 133
119
These three theses demonstrate a range of strategies used by African

American students for constructing medical authority: borrowing the emer-
gent institutional authority of the institution; translating science into a source
of socially sanctioned knowledge; and disguising the race, position, and even
the opinion of the cross-dressed writer. None of these strategies organized a
productive medical discussion about race, a problem which, as we have seen,
was still unresolved when W. E. B. DuBois surveyed health conditions in 1898
for The Philadelphia Negro. But in Anderson’s and Bennett’s theses, scientific
knowledge is joined with the student’s experience, mediated through her
medical education, to offer a way of speaking as a doctor, whether as a prac-
titioner of what Bennett called “the great medicine of the future, Preventive
Medicine,” 134 or as Anderson’s cool, heroic surgeon.
Did the graduates of the Woman’s Medical College, then, write science dif-
ferently from the graduates of the University of Pennsylvania? Yes and no.
The two registers of health and of medicine construct two kinds of bodies,
two accounts of medical practice. The differences between these two regis-
ters are as marked as the differences between the most distinct male and
female performances within each of them. Very many passages in very many
theses are not at all marked by gender differences, and these passages often
work out the serious intellectual problems of the essay, negotiating incom-
patible understandings of the body in more or less consistent ways. In their
approach to therapy, women did not differ from men, a finding that has been
stable in studies of women physicians since Morantz-Sanchez’s pioneering
work.135
Although doing medicine was quite similar for men and for women, being
a doctor was not, particularly when the doctor was African American. In
particular, the marginalization of the struggling Woman’s Medical College
set rhetorical problems for its graduates and deprived them of a rhetorical
support that was quite commonly used in the theses written at the University
of Pennsylvania. While a male medical student could present himself com-
fortably as a “tyro” or an “apprentice,” a new woman graduate could not. If
women were to be doctors at all, they must be heroic doctors, inheritors and
inaugurators of an honored tradition. Such a stance, of course, placed an
impossible strain on the decorum of the student essay, not to mention the
obligatory modesty of a woman moving from her separate sphere. It is not a
small part of their achievement that women students found solutions to the
problem of authority that were not self-abnegating.
This chapter has been a long argument for local knowledge, an argument
against seeing women’s perceptions or scientific interests as necessarily con-
nected to a feminine cooperative nature or an inherent disposition toward
disclosure rather than objectification. In these texts, we hear singular voices,
120
those of women who believed that electricity flowed in the ground like water
and that the ovaries prompted labor; I want to take them seriously as scien-
tists, working on the scientific issues that faced medicine in the middle of
the nineteenth century. Their performance of these discourses was never
simple; medical discourse, after all, represents women’s bodies as objects of
a particular kind of knowledge. These writers were among the first to answer
that representation as subjects; we misunderstand them if we forget either
their commitments as scientists or their experiences as women.
121
5
Invisible Writing II
Hannah Longshore and
the Borders of Regularity
Hannah Longshore (1819–1901) is at once more obscure and more available
to us than Ann Preston. She maintained a careful distance from the Woman’s
Medical College and its alumnae association and never identified herself ex-
clusively with any institution. But unlike Martha Sawin and Phebe Way, she
did not vanish from the public record. Although Hannah Longshore’s career
was grounded in active clinical practice—forty patients a day, by her hus-
band’s account—she also wrote and spoke in public. And her large, vocal,
active family connected her to reform circles. Her brother-in-law Joseph
Longshore (1809–79) was a well-known radical, active in the Underground
Railroad and women’s rights movements and also in temperance, spiritualist,
and vegetarian circles; he was among the founders of the Woman’s Medical
College of Pennsylvania.1 Her sisters, Jane Myers and Mary Frame Myers
Thomas, also became physicians, graduating from Penn Medical University,
an Eclectic school founded by Joseph Longshore after he left the Woman’s
Medical College. Mary Frame Myers moved to Indiana, where she collected
supplies for the Union during the Civil War and worked on the suffrage pa-
pers The Lily and The Mayflower.2 Anna Longshore-Potts, her sister-in-law,
was also among the first graduates of the Woman’s Medical College, traveled
to Australia and New Zealand as a lecturer, and published both her lectures
and a book, Love, Marriage, and Courtship.3 Her obituary also mentions
travels to India, Britain, and Ceylon; she died in San Diego in 1912.4 Hannah
Longshore’s daughter Lucretia, later Lucretia Blankenburg, was the wife of
a Philadelphia reform mayor and herself a proponent of public health mea-
sures; she popularized a version of her mother’s biography in which the
daughter’s girlhood sufferings were prominent.5 Hannah’s husband, Thomas
Longshore, kept her notes, wrote her lectures, and wrote extensively, os-
tensibly on religious topics. This chatty and opinionated family surrounded
Hannah Longshore with a web of stories; we can know things about her that
we can never know about Ann Preston—what she ate for breakfast, what
she was like as a mother. And, just as the early theses of Woman’s Medical
122
College students speak to their location within the school and the institutions
of medicine, Hannah Longshore’s writing can be placed, with that of her fam-
ily, in the social world of reform, where science and health were intimately
connected with religion and politics. These texts supplied Hannah Long-
shore with characteristic tropes; looking at her writing in the context of the
discourses that circulated around her, we can understand better her perfor-
mance of the anomalous role of the woman physician.
Hannah Longshore’s favored strategy for that performance was travesty, a
characteristic trope of the Longshore family. When they seemed most con-
ventional in their reproduction of received forms and genres, the Long-
shores were often using them against their grain. Particularly in the case of
Hannah Longshore’s gender performance, travesty supported complex and
doubled positions: admiration was overlaid with pointed criticism. Travesty’s
attitude toward its objects has often been contradictory. The medieval Sec-
ond Shepherds’ Play, with its parody of the nativity, is a deeply reverent (and
very funny) retelling of the Christmas story; Scarron’s Virgile Travesti (1648–
52) was an elaborate tribute to the Aeneid. But travesty, burlesque, and “tak-
ing off” have also organized devastating satirical attacks. (Oddly, all three
terms are associated with clothing; burlesque and taking off are associated
with stripping, while travesty is etymologically identical to cross-dressing.)
And the contemporary common use of travesty—“travesty of justice”—sug-
gests that such attacks have serious consequences.
Longshore was a parodist in her use of medical forms; she took them on
as disguises, but subtly overturned them. In her most extended performance,
her response to a toast delivered at the annual banquet of the Woman’s Med-
ical College Alumnae Association, she travestied institutional identifications,
medical regularity, and medical biography as practiced in nineteenth-
century Philadelphia.
THE FIRST CASE: HANNAH AND HER SISTERS
Hannah Longshore spoke often in public, but her only surviving speech is a
narrative of her life delivered to an audience of medical women. Longshore
replied to a toast at an annual supper of the alumnae association of the Wom-
an’s Medical College of Pennsylvania, probably in 1895. At least on the sur-
face, Longshore performed the role of an exemplary scientific professional,
but she also used her personal narrative to refuse affiliation with her audi-
ence and to suggest alternates to the scientific regularity of her alma mater.
The speech is therefore a disguised attack on the solidarity that it celebrates.
Since we have her speech in both its final version and a number of rough
123
drafts, we can reconstruct Longshore’s work of composition and understand

both what her toast said and what it did not say.
The toast was a specific speech genre, staged in a complex site. The Wom-
an’s Medical College Alumnae Association was a professional home for
women doctors in Philadelphia, barred as they were from the Philadelphia
County Medical Society. The alumnae supper was carefully orchestrated,
held after a day of scientific papers and clinical reports. New, old, and re-
turning members wore distinctive ribbons. It was not easy to organize a sup-
per that all members could enjoy; arrangements about wine were especially
vexing, since many members were abstainers, and some refused even to en-
ter an establishment that served alcohol. An early president of the associa-
tion, Mary Putnam Jacobi, commented:
I do not see that the fact that two ladies were so extremely squeamish as not
to come to the Hotel Bellevue for the reason alleged, ought to influence the
Association. Nothing could be more free from alcohol than our own supper last
night. If anything could have been added to make the table look prettier, it
would have been some sparkling wine. It is not necessary to drink, but it is al-
ways pretty to look at.6
Toasts, taken with water or other nonalcoholic beverages, were the high
point of the evening; usually given by an officer of the alumnae association
or a member of the faculty, they honored groups of female physicians and
their supporters. The toasts addressed groups in the audience, such as “the
New Graduates” or “Our Forerunners.” A representative of the toasted
group would “reply” with another short speech.7 Although the members of
the alumnae association were educated women, members of a respected
profession, they found this ritual daunting. When the association debated
inviting men to the banquet, its members demurred; they preferred to have
their first efforts at toasts and replies remain unwitnessed by the “specially
dinner-giving and speech-making sex.” 8 The toasts and replies ring the
changes of the epideictic, from the sentimental through the humorous to the
heroic. In 1892, Mary Putnam Jacobi toasted the corporators; “Mrs. Mum-
ford responded in a witty speech”; and Jacobi responded with the joke (it
must have been old, even then) that “to look at me, of course, you will not
realize how completely that period belongs to ancient history.” 9 On other
occasions, dead alumnae or the sacrifices of medical missionaries were hon-
ored. Similar after-dinner toasts at University of Pennsylvania alumni events
included both serious policy speeches and humorous or sentimental perfor-
mances. At the 1875 University of Pennsylvania alumni dinner, for example,
the toasts were followed by “several songs,” and the “company did not sepa-
rate until a late hour.” 10 As a speech genre, the toast was linked to males,
and expressed a professional urbanity alien to women physicians, even those
124
used to lecturing and public address. The woman physician who rose to
make a toast or to reply to one, then, was undertaking a gender-marked per-
formance, one that she and her spectators understood as male.
Though new at making toasts, Hannah Longshore had extensive experi-
ence in communities which accepted women in public speech roles. Like
Ann Preston, Hannah Longshore was a Quaker, associated with the Hicksite
group and familiar with their practice of plain-spoken female preaching.
Quakers did not generally accept women as congregational overseers or as
rule-givers but did value them as intuitive, inspired preachers.11 In Long-
shore’s connections with the spiritualist Harmonial Circle, she would have
encountered women as authorized speakers, skilled negotiators of the bor-
ders of life and death.12 Finally, as a close friend of Lucretia Coffin Mott and
a participant in the midcentury reform movements, Longshore would have
heard effective women speakers in a variety of styles and situations.13
At the time of her speech, Hannah Longshore was nearly eighty years old,
veteran of forty years of medical practice. Her four teams of horses and her
house in fashionable Logan Square spoke of her professional success; her
simple dress, Grahamite diet, total abstentionism, and spiritualism linked
her to the diverse medical reform movements of midcentury; her suffragism,
abolitionism, and membership in international peace societies connected her
to Philadelphia Quaker activism. The speech she gave was an autobiographi-
cal narrative, an account of her experiences as a medical pioneer. Long-
shore’s career intersected with the increasing professionalization of medicine
and with the entry of women into “regular” medical practice; her speech
organizes these complex events as a simple dramatic narrative.
In its final version, Longshore’s talk is a story of triumph over opposition.14
Longshore recalled that “the first women physicians in Phila. did not find
their paths strewed with flowers nor their advent welcomed by the general
public or by the profession.” She remembered the threatened disruption of
the first graduation by male medical students and the rude comments that
greeted the sign “Hannah Longshore, M.D.” on her window shutter. And
she remembered early triumphs: her cure of a patient who had been given
up, her growing practice. Since pharmacists refused to fill Dr. Longshore’s
prescriptions, she began to compound drugs herself and to carry them in
an emergency case. Longshore’s struggle to prescribe and administer drugs
figured in the climactic episode of the speech:
A little later the following incident occurred; I went to one of the leading
pharmacist to purchase an ounce of Sulphate cinchona, placing my business card
on the counter, the proprietor looked at it and then at me and said “I will not
sell this cinchona to you” you are out of your sphere “go home and darn your
husbands stockings! Housekeeping is the business for women” I informed him
that the stockings were darned, my house was probably as well kept as his, and
125
as a graduate of the Female Medical College, chartered by the Legislature of

Penna. I proposed to practice medicine as long as the women of Philadelphia
saw fit to employ me, and I have the strength to work. And laying my emergency
case open on the counter told him it had kept dollars out of his business and
would keep more. Bystanders listening to the episode indulged in such flippant
remarks as “strong minded woman” and “go it while you are young” and made
the scene more annoying by their vulgar epithets, I turned to leave the store
when near the door the proprietor called to me, and said you can have the cin-
chona for two dollars,” I observed that $1.50 is the price to physicians when he
consented to take that sum.15
This is, of course, a very good story, a story that has been honed and re-
hearsed. In three of the four versions of the speech, it is the centerpiece of
her performance, written with few corrections, in words virtually identical
to those used for the final version. Hannah Longshore’s is a straightforward
account of plucky self-assertion, professional confidence, and economic self-
interest victorious over prejudice—a triumph of liberal feminism.
Longshore’s story also negotiates quite complex relations with both her
immediate audience and the profession in which she had prospered. It bid
for her inclusion in the institutional memory of the Woman’s Medical Col-
lege, a history from which she and her family had been virtually erased; with-
out mentioning her family, this speech reinscribed them into the history of
the institution. From the 1860s until the end of the century, the role played
by Hannah’s brother-in-law Joseph Longshore in founding the Woman’s
Medical College of Pennsylvania went unmentioned in its official docu-
ments, which treated the college’s first ten years with elegant vagueness.
Only in the twentieth century—after this speech and Lucretia Blankenburg’s
promotional efforts—do we read references to darned socks and medicine
cases in the publications of the institution. Hannah’s was a good story that
had been in danger of being lost; the Woman’s Medical College had to forget
its initial conflict with the Longshore family before it could afford to remem-
ber Hannah Longshore. But instead of going quietly into the institutional
pantheon, Hannah inscribed in her story an indelible reminder of that
conflict.
The Woman’s Medical College had taken advantage of the relative open-
ness of professional medicine in the mid-nineteenth century and of the Jack-
sonian willingness of legislatures to charter new schools.16 Given the exuber-
ance of medical styles and the wealth of irregular schools,17 a female medical
college was one transgression among many, and we can see in Longshore’s
claim that she had graduated from a school “chartered by the Legislature of
Penna” an assertion of her relative respectability, of the regularity of her edu-
cation. Ann Preston would have been proud of such a compliant speech
performance.
126
The path of the early graduates was not “strewed with flowers,” but nei-
ther was that of its founding teachers, recruited from various corners of the
profession. Many of the physicians came to the women’s school from reform
circles; like other reform-minded people, they were interested in alterna-
tives to regular medicine—dress reform (to avoid restrictive corsets), the
water cure, and mesmerism. The first classes at the Woman’s Medical Col-
lege heard lectures from the homeopathist Livezy and from Seth Pancoast,
author of several works on light therapy. These physicians taught for derisory
sums. While medical school professorships were never expected to support
a professional career, pay was especially scanty at the Woman’s Medical Col-
lege. The faculty minutes for February 7, 1863, report that twenty-seven
dollars in student lecture fees would be divided among the seven faculty
members—physicians who had cut themselves off from the Philadelphia
County Medical Society and from consultation with its members. Not all the
faculty, and least of all Joseph Longshore, were willing to comply with the
regular medicine that had rejected them. The early minutes of the Woman’s
Medical College faculty, especially those from 1850 to 1860, show a constant
struggle, seldom explicit, to limit professorships to regular rather than Eclec-
tic doctors, leading to a complete turnover of the faculty during the first
ten years of the institution, many chairs being filled by recent graduates of
the college. By 1860, the Woman’s Medical College was no longer a hotbed
of political activism and free thought. Reform energies were focused on the
war, and the faculty—now mostly women—presided over a medical school
that was struggling and controversial but in every other way conventional.
Joseph Longshore, a founder of the Woman’s Medical College, resigned
during those struggles; a militant total abstentionist and a believer in the
water cure, the use of electricity, and mesmerism, he was apparently reluc-
tant to limit his instruction to regular medical topics. Even his gynecological
theories were controversial; Longshore’s emphasis on the ovaries placed him
at odds with a physiology that still focused on the uterus.18 Thomas Long-
shore, Hannah’s husband, tells the story of Joseph Longshore’s exclusion in
his unpublished “History of the College”:
I was present on one occasion when Dr. Johnson (the Dean) openly attacked
Dr. Longshore, charging him with his unfitness, and severely criticizing him and
denouncing him for his defects in style and manner in which he illustrated and
expounded the theory and practice of obstetrics. He made things too plain
and full for the fastidious sense of propriety and false modesty of Dr. Johnson,
when speaking to a class of ladies. Dr. Longshore was interested in what was
then called Woman’s Rights, Total Abstinence from intoxicants, in mesmerism
and the phenomena of Modern Spiritualism, and would use the arguments, the
facts, and what appeared as the natural forces, influences or principles devel-
oped by these and the nerve theories of occult Sciences, in connection with the
127
practice of medicine. He had seen a marvelous power exerted by mesmerism in

his own practice, and would refer to it in his public lectures before the class.19
Joseph Longshore resigned from the Woman’s Medical College in March

1853 to found the coeducational Penn Medical University, an Eclectic school
that welcomed faculty of various medical persuasions and offered an inno-
vatively organized medical training to both men and women in separate
departments.
Not surprisingly, Joseph Longshore’s disputes with the Woman’s Medical
College affected Hannah Longshore’s relations with her alma mater. After
graduation, Hannah took up a faculty position as Demonstrator of Anatomy
at the Woman’s Medical College. She resigned that post at the end of 1853
to become Demonstrator of Anatomy at the Penn Medical College. And
Hannah must have been affected by the general purge of sectarians; her
“hidden” thesis title, “Neuralgia: Its Cure by Water,” inscribed, not on the
title page, but on the first page of the text, was only one sign of her irregular
tendencies. She gave a course in “psychiatry” to the Harmonial Circle, a spir-
itualist group, which, for that audience, meant the study of spirits. In her
own practice she was “not governed by any routine, nor limited to one school
of medicine, but considers that she is at liberty to avail herself of any means
which her experience has proved useful or the peculiarities of the case sug-
gest.” 20 Often, the peculiarities of the case suggested homeopathic remedies.
Unlike Joseph Longshore, who enjoyed and sought controversy, Hannah
generally abstained from conflict. One of her letters discussing the Hicksite
controversy, dated May 1850, laments, “Who are ‘friends’ nowadays which
way do Lisbon friends go—How do those at Salem and Beighton? How hate-
ful is sectarianism the more of it the less humanity the less goodness.” 21
After the exclusion of the irregulars, Hannah Longshore kept aloof from
the Woman’s Medical College of Pennsylvania, never joining the alumnae as-
sociation. She did not visit the college unless she was specifically called, never
consulted with the faculty, and devoted herself to her practice and her family.22
Although she was one of the preeminent women physicians in Philadelphia,
seeing many patients and supporting her household at increasingly fashion-
able addresses, within the Woman’s Medical College she was never men-
tioned as a model, invited to address the college, or even listed among promi-
nent graduates during the first forty years of the school’s history.
At the alumnae dinner of 1895, then, Hannah Longshore encountered an
institution from which she had been separated and which she had avoided
for forty years. In her assertion that she was a competent physician because
she was “a graduate of the Female Medical College,” Longshore replaced
herself in the history of the institution, asserted the legitimacy of her own
“memories of olden days,” and joined her own early struggles to those of the
128
institution and its more regular graduates. By 1895, after all, Joseph Long-
shore was dead, and the battles between homeopaths and regulars were dim
memories. The adventure of the medicine case would be incorporated into
the public narrative of the institution.23
Hannah Longshore’s reply, then, took up the cover of regularity and drew
it decently over a past scandal. But covering something is also a way of draw-
ing attention to it, and Longshore’s adoption of the language of regularity is
also a travesty, a shifting of apparel that makes the normal seem strange,
even ridiculous. Longshore was speaking to an audience of “co-workers” to
whom she remained an unorthodox figure. For them, the drug Longshore
ordered, sulphate cinchona, would have been significant. Longshore named
cinchona only in the final version of the speech; in the two early versions of
this story, she simply referred to “some ounces of drugs.” Derived from the
same plant that produces quinine, cinchona was one of the few items in the
mid-nineteenth-century pharmacopoeia that was really effective; it was a
specific for intermittent fevers, although it was probably less effective for
scarlatina, rubeola, or typhoid, for which it was also prescribed. The drug
was also associated with the history of women’s medical work; in the words
of Ella Upham, author of “Women in Medicine”: “A Spanish lady, the Count-
ess de Cinchona, wife of a Viceroy of Peru, was attacked by the fever of the
country. She insisted upon trying the Indian remedy of Peruvian bark, which
had not then attracted the attention of any European. She was speedily
cured, and on her return to Europe in 1632 she made a great effort to spread
the knowledge of the new medicine.” 24 In asserting her right to cinchona
at the physicians’s rate, Hannah Longshore was claiming her professional
inheritance. But not only that.
Cinchona evoked, tacitly, the conflict that had led to the Longshores’ rup-
ture with the Woman’s Medical College and asserted Hannah Longshore’s
continued separation from the tradition of regular medicine. “Women in
Medicine” was, after all, published in the North American Journal of Home-
opathy; there, cinchona appeared as the paradigmatic homeopathic remedy:
“It was in the use of a preparation of Peruvian bark that Hahnemann ob-
served that if administered to those in health it produced a fever similar to
the one it was given to cure; from this was evolved our law of similia. Thus
we are indebted to the discoveries of this woman, supplemented by the wis-
dom of Hahnemann.” 25 Cinchona signified not only the resources of women
in medicine but the “wisdom” of homeopathic methods. No homeopathist
would have used cinchona as a sulphate; cinchonida sulfate, a cheap form of
quinine, began to be very commonly prescribed by regular physicians in the
1870s.26 But cinchona was a resonant word in both the homeopathic and the
regular vocabularies.
That resonance would have been difficult for Longshore’s audience to
129
contain, because so many of them might have remembered, and suffered

from, women patients’ interest in homeopathy as an alternative to harsher
regular therapies. Hannah Longshore had studied homeopathy after her
graduation; like many other women physicians, she found that patients dis-
liked large doses of strong and disagreeable medicines, which were, in any
case, falling from favor under the influence of French clinical medicine. In
the words of Thomas Longshore, “Many intelligent women had become tinc-
tured with the heresy of Homeopathy.” 27 Longshore’s mention of cinchona
tacitly questioned the central strategic choice for regularity that character-
ized the Woman’s Medical College in general and Ann Preston in particular.
Longshore at once claimed and refused membership in the discourse com-
munity of female physicians. Like them, she was heir to the tradition of wom-
en’s medical work; unlike them, she did not exclude homeopathy from that
tradition. She is a part of the group she speaks to and apart from them.
Hannah Longshore’s reply to the toast repeated the central action of her
story, the defiant display of the medicine case from which she had dispensed
throughout her career. She metaphorically opened that case upon the ban-
quet table and told her audience that it had taken dollars from them and
would take more. The moral would not have been lost on them: Hannah
Longshore was a wealthy woman, preparing to fulfill her lifelong dream of
traveling to Europe. Her audience was asked to identify with her victory but
also to be chastened by it. Her doubled evocation of contradictory relation-
ships, relationships of admiring affiliation and distanced criticism, is con-
tained by Longshore’s entirely conventional performance of a deeply con-
ventional genre. The toast has been travestied: it is not that Longshore’s
performance was contemptuous of her audience but that she enacted both
her connection with them and her distance from them.
We can hear in Hannah Longshore’s 1895 speech the echoes of her
brother-in-law Joseph Longshore’s 1851 valedictory address to the first grad-
uates of the Woman’s Medical College. Joseph Longshore claimed for the
new women’s college equality with celebrated Philadelphia medical schools,
the University of Pennsylvania School of Medicine and Jefferson Medical
School:
By an act of incorporation, by the legislature of the commonwealth of Pennsylva-

nia, your Alma Mater has been placed on an equality, in chartered immunities,
with that colossal Institution of our city, around which the names of Kuhne,
Wistar, Rush, Godman, Physic, James, and Dewees cast a halo of unfading glory;
or her proud and successful rival, with the history of which are identified the
imperishable names of Eberle, McClellan and Revere.28
But those institutions were known for their irreproachable regularity, a regu-
larity that Longshore steadily undercut in the rest of his speech. The author-
130
ity of these schools was passed through an unbroken line of male ancestors;
Longshore satirized their opposition to women physicians: “Many there are
who will make it a matter of conscience, believing that woman is sadly wan-
dering from her legitimate sphere, when she attempts, scientifically, to ad-
minister to the necessities of the sick and suffering—though to do it igno-
rantly and empyrically, would seem to be within her appropriate province.” 29
Against common regular practice, he urged graduates to avoid prescriptions
based on alcohol. Longshore even cast doubt on the scientific value of regu-
lar medicine: “While we regard the system of medicine in which you have
been instructed, technically called Allopathy, as embracing within its expan-
sive range, more of truth and philosophy, than is possessed by any other
claiming the attention of the Medical Student, we are very far from viewing
it as the embodiment of perfection.” 30 Longshore’s “technical” term for the
school’s curriculum violated a shibboleth of regularity; allopathy was a term
used by homeopaths and other irregulars, never by regular physicians them-
selves. Longshore urged graduates to investigate alternatives and hoped for
“a more perfect and beautiful system.” He was promoting the Eclecticism
that would lead to his resignation, blandly asserting it as the policy of the
school. Longshore’s valedictory, then, established his doubled relation to reg-
ular medicine and to the school whose success he celebrated; he borrowed
their authority but distrusted their practices.
Hannah Longshore’s speech, like Joseph Longshore’s valedictory, can be
located within a genre of ceremonial academic performances; in this context,
travesty is directed at institutional membership and scientific regularity. But
Hannah Longshore’s performance of membership and distance is organized
as a life story and so also responds to the generic exigencies of autobiography.
She told the traditional story of the isolated, triumphant subject, in its
middle-class inflection—the narrative of professional success. Within the
growing scholarship on women’s autobiography, such narratives are seen as
typically male, and women’s autobiographies are described as episodic,
closer to the journal or diary than the triumphant unitary narrative, and
shaped by issues of relationship and personal connection.31
Longshore’s narrative of solitary success against odds is just the sort of
story women are not supposed to write, even though such stories are not
difficult to find; we might remember Ann Preston’s escape with a disguised
fugitive slave. Stories of individual assertion figured in the most retired lives.
The early graduate Rebecca Fussell never practiced medicine or was heard
of in any public way, but, sitting on the speaker’s platform during an aboli-
tionist meeting in Ohio, she thrust her infant son between Frederick Doug-
lass and a club-wielding proslavery thug.32 Neither Fussell nor Preston told
her own story publicly, leaving them to their families or colleagues. And
these are stories in which a woman saves others rather than claiming her
131
own rights. To tell a heroic story about herself, with no invocation of divine
succor or any other external support, was an unusual, if not a singular, perfor-
mance for a woman of Hannah Longshore’s generation. Hannah’s life story
violated the Quaker stricture against self-promotion, a convention so strong
that one eighteenth-century writer revised his autobiographical journal three
times to eliminate as many instances of the pronoun I as possible.33 Espe-
cially since her story established Longshore’s distance from the regular com-
munity of the Woman’s Medical College—she has entered a professional
community but not exactly their professional community—her speech for-
bids any easy connection of the feminine with the relational (dare we say,
with what is nice?). There was no easy negotiation between Hannah’s con-
nections to her professional community and those to her family. Connection
could not be, in this singular life, a univocal goal or state; rather, Longshore’s
connections, as she would have called them, were formed around issues of
both professional practice and familial relationship, around both intellectual
and financial investments. Her narrative does not resolve those contradic-
tions and antagonisms; it represents them, performs them.
While Longshore’s narrative is not a conventional feminine autobiography,
it also travesties the specific conventions of late nineteenth-century medical
biography. Longshore would have encountered such biographies as part of
her professional reading; she subscribed to medical journals and could have
read memorial notices such as those published in the transactions of the
College of Physicians of Philadelphia. William Osler’s biographical essays,
originally delivered as addresses to various medical schools and institutions,
can serve as an example of this form.34 In his biography of Philadelphia physi-
cian William Pepper (could he, perhaps, have been the Doctor Pepper?),
Osler described a relentlessly coherent career. We hear of Pepper’s educa-
tion and early practice, of his service as provost of the University of Pennsyl-
vania, and of his mature work (divided into three phases, treated seriatim).
Osler ends with Pepper’s death in Hawaii with Treasure Island in his hand.
This is an unbroken story of success, uninterrupted by personal singularities,
by any incursion of corporeality. In Osler’s account, Pepper had a father but
no mother and certainly no wife or children. Hannah Longshore’s speech,
too, presents her as emerging, solitary and heroic, battling against the odds,
effecting cures impossible for other physicians. But Longshore deploys these
topics in remarkably demystifying ways; Pepper never had to account for
undarned socks. And her discomfited druggist, finally relenting on his price
by degrees, is a ridiculous opponent rather than a dangerous enemy. Long-
shore’s life story, then, performed her doubly negated travesty: Longshore
was not a woman, not a doctor, but a woman doctor.35
Hannah Longshore’s speech also travestied the Quaker genre of biograph-
ical testimony; she used its associative structures but refused its modest self-
132
presentation. Examples of Quaker biographies can be found in The Journal,

a short-lived Hicksite paper which also published many of Thomas Long-
shore’s religious essays, and in the orthodox Friends’ Intelligencer. A typical
memorial notice presented the subject’s life as biographical testimony.36 It
represented a life directed toward serious ends but also offered a sense of
the singularity of the subject; we read of family relations, hobbies, and tal-
ents. While the memorial conventionally moved from the subject’s birth to
death, its central sections were associative in their organization. The writer
focused on the “testimony” or “witness” of the subject’s life, particularly in
the face of suffering, told as a series of loosely linked episodes. These texts
are quite similar to the memoirs of British clergymen’s wives described by
Linda Peterson: discontinuous and fragmentary documents that originated
in private circumstances and are published for purposes of edification.37
Longshore’s speech, like these memorial narratives, offered her life as a wit-
ness, but its edifying message diverged from Quaker formulas; this was a
prominent public life, presented as a quite worldly success.
Hannah’s husband, Thomas, wrote much more extended narratives that
refunction the genre of memorial biography to present an unorthodox reli-
gion of science. The most sustained, if not the most finished, of these docu-
ments is Thomas Longshore’s “Autobiography,” a manuscript in which he
tells the story of Hannah Longshore, investing her life with heroic and trans-
gressive significance while maintaining the genre decorum of testimony.
Handwritten in a ledger, “Autobiography” is well over a hundred pages long
and still carries the marks of its composition: small pieces of paper with notes
and drafts are inserted into the notebook, and the narrative breaks off once
to describe what Hannah is doing as her husband writes and again to record
what he believed were her dying words. Although it begins in the first per-
son, with an account of Thomas and Hannah’s first meeting, the text rapidly
becomes a memoir of Hannah’s life. (The title “Autobiography” was assigned
to the text after Thomas Longshore wrote it, probably because of its opening
words: “On the 2th of February 1835 the writer left the paternal roof . . .”).
The text cannot have been written before 1882; while internal evidence
dates one section of the manuscript at 1892, it does not mention Hannah’s
retirement that year or her tour of Europe soon after.
This text of Thomas Longshore’s evokes the discontinuous, episodic struc-
tures we associate with women’s autobiographies. And Thomas Longshore’s
authorial presence was as complicated as that of an anonymous woman
writer; many of his publications were uncredited or signed with various ini-
tials. But especially when contrasted with the hagiographic pallor of our pic-
ture of Ann Preston, Hannah Longshore emerges in this account as ener-
getic, singular, difficult, and massively interesting. Thomas Longshore speaks
of her habit of standing out in thunderstorms, of her sewing all the family’s
133
underwear, of her falling asleep whenever she took time to sit down, of her
breakneck carriage rides through the city, and of her “toleration for a large
liberty” among her friends and family.38
Thomas Longshore’s published biography, George Fox Interpreted (1881),
casts light on the fascinating morass of his “Autobiography” and on what was
at stake in the Longshore family trope of travesty. In George Fox Interpreted,
Longshore subordinated biographical narrative to the exigency named in his
subtitle: to interpret Fox “. . . in the Light of the Nineteenth Century and
Applied to the Present Condition of the Church.” Fox was, for Longshore, a
scientific rationalist disguised as a Christian. George Fox Interpreted traves-
ties the Quaker witness story, transposing the story of the original Quaker
into a criticism of religion in general. The canonic episodes of Fox’s life are
interpreted as exempla of his scientific spirit, so that Fox’s plain dress made
of leather was motivated solely by reason and economy. Fox renounced
oaths, incurring heavy penalties, because prudence prompted him to reject
superstitious ceremonies from pagan sources.39 Using etymological argu-
ments, Longshore interpreted god as synonymous with the good, arguing
that Fox personalized the good only to accommodate superstition. Long-
shore himself was deeply skeptical of any stable distinction between good
and evil: “. . . what is called good and evil by finite, fallible men, in what is
transpiring in the outer world, are so inseparably blended, and necessary to
constitute the whole, that the good could not exist without the evil, nor the
evil without the good; and our distinction of them is entirely arbitrary and
determined by the way we are affected by them.” 40 Etymologically, Holy
Ghost became “benign gasses”; and inspiration, the breath. Fox was a scien-
tific savant, not to mention a health reformer, avant la lettre.
Longshore’s biography of Fox is reflexive and self-replicating. If Fox was
a reform-minded “scientific spirit” 41 whose religious statements were canny
adaptations to a society under the sway of religious myth, what are we to
make of the biographer Thomas Longshore, a public-spirited believer in sci-
ence, who writes as a Christian (to an audience concerned with doctrinal
orthodoxy) while rejecting belief in a personal god or an afterlife, let alone
the divinity of Christ? Longshore fashioned himself to represent the asceti-
cally “scientific spirit” he found in Fox. If his “Autobiography” is actually a
memoir of his wife, Thomas Longshore’s real autobiography is perhaps to be
found in George Fox Interpreted, the story of a master of disguise, a travesty
of the Quaker witness story of suffering and consolation. When Thomas
Longshore and his family wrote about science, they could well mean religion;
when they wrote about religion, they could well mean science.
Thomas’s biography of Hannah Longshore, therefore, is a celebration of
her scientific spirit and desire for reform. The stories we read as demonstra-
134
Figure 7. Hannah E. Longshore, autobiographical speech, first version (Archives and Special
Collections on Women in Medicine, MCP Hahnemann University)
tions of her singularity actually serve as evidence of Hannah’s rationality,

economy, or devotion to the scientific “laws of life.” Hannah “all her life . . .
believed it best to sleep in rooms winter and summer with windows and
doors wide open. For forty years this has been her constant practice with the
full belief that she did it to her great advantage.” 42 For us, this habit speaks
of Hannah as a flinty pioneer, her bedroom ventilated by midwinter gales.
But in both George Fox Interpreted and in The Higher Criticism in Theology
and Religion, Thomas Longshore argued that the Holy Ghost is the benign
gas that inspires men with reason and benevolence as against the evil spirits
of alcohol and opium. In this light, Hannah’s relentless pursuit of fresh air
aligns her with the forces of godlike, but essentially scientific, inspiration.
While Preston’s invisible writing was inscribed anonymously in the docu-
ments of the Woman’s Medical College of Pennsylvania, Longshore’s invis-
ible writing was fugitive and displaced. Her words were tied to particular
occasions of utterance, so deeply situated in familial and social contexts that
they are almost unintelligible to us. When we hear her voice, the voice that
“is not afraid to die,” that is “possessed of some genius and curiosity for in-
quiring,” it reverberates with other discourses, taking them on and translat-
ing itself into their alien forms.43 Such a performance did not come easily to
Hannah; it was painstakingly composed, thought through, and revised. In
three early drafts of her speech, Longshore experimented with alternatives
to the story of success against the odds. The first two versions of the speech
tell stories of pleasure and community. (See figures 7, 8, 9.) Only in its final
version do we read Hannah Longshore’s masculine story of triumph over
difficulties:
135
Figure 8. Hannah E. Longshore, autobiographical speech, second version (Archives and Special
The first women physicians in Phila. did not find their paths strewed with
flowers nor their advent welcomed by the general public or by the profession.
They encountered no little bitterness, opposition, and persecution.
In the second draft, however, medicine was a source of childhood pleasure:

If as a physician it may be thought I have in any sense made a success it was
not from any extraordinary or exceptional advantages that have fallen to my lot.
As a child I was not strong in physic nor energetic and aggressive in spirit or
purpose, but possessed some genius and curiosity for inquiring, analyzing and
solving such problems as were presented to a juvenile mind.
The structure of the bodies of insects, rodents and domestic animals enlisted
my attention, and to satisfy my inquisitiveness, I ventured to attempt the experi-
ment of dissecting some parts of these as at times convenient they fell into my
hands, perhaps merely to indulge a freak.
And in the first draft, medicine is Longshore’s patrimony:

I owe much of my interest in science to the instruction received from my
father. As a little girl living on a farm in the then new state of Ohio, I was at-
tracted to the study of anatomy and embraced every opportunity that offered to
satisfy this taste. To be a doctor was the desire and ambition of my girlhood.
These early drafts do not tell a story of unremitting effort against the odds.
Longshore described her choice of a medical vocation as a matter of attrac-
tion, almost seduction:
Science applied to life to lessen human misery and multiply human comforts
had in the thought a charm and enchantment that could not be relinquished, so
136
Figure 9. Hannah E. Longshore, autobiographical speech, final version (Archives and Special
long as it was possible for any way to open where it could be in some measure
realized. (second draft)
She spoke of reform politics, of her close relation to her husband, of her
reliance on the support and encouragement of her family. None of this mate-
rial appeared in the final draft of the speech; all these expressions of plea-
sure, of delight in science, of political commitment, of family connection
were omitted from Hannah Longshore’s memoir of “early years.” But pre-
cisely these topics—wayward and independent scientific research, politics,
the Longshore family—were the points of tension between Hannah Long-
shore and the Woman’s Medical College. In order to produce one narrative
of pleasure and difficulty, Hannah Longshore has re-created exactly the si-
lences and exclusions that made her narrative necessary. Her story of plea-
sure, knowledge, and connection was elided, and appeared in the final text
as a bitter taste of cinchona.
Such revisions suggest that the strategy of travesty was a solution, and
perhaps not an entirely satisfactory solution, to the rhetorical problems
Longshore faced as she took up the urbane masculine form “replying to a
toast.” One of the stories she might have told—the story of family connec-
tion and support—would have brought her close to an explicit mention of
her brother-in-law’s role in founding the school. Other stories of pleasure,
delight in seeing the interior of the body, “perhaps as a freak,” may have
seemed insufficiently edifying. In the end, she took up the contradictory sto-
ries of solitary success against all odds, of the faithful disciple witnessing her
calling, and turned them to her own purposes. Her speech demonstrates the
demanding possibilities of travesty; she disputes the easy regularity to which
the received forms of medical discourse aspired. Longshore’s narrative of
personal success reminds us that scientific arguments can, and often do, en-
code personal stories.44 Her cordial and aggressive claim and refusal of mem-
bership remind us that connection is not the special province of women but
has been part of the ongoing work of science since Boyle staged his first
experiments with the vacuum as spectacles and bids for patronage.45
THE SECOND CASE: HANNAH LONGSHORE

WRITES REGULAR MEDICINE
Eleven years before her autobiographical speech, Hannah Longshore had

published her sole written intervention into medical controversy. Her “Case
of Conception Without Intromission” appeared in the Medical and Surgical
Reporter, published in Philadelphia, in 1884; it responded to a contemporary
debate about conception.46 The correspondence columns of the Medical and
Surgical Reporter were lively and central to the journal; they included letters
138
from other journals and were themselves often reprinted. Longshore’s letter
resembles what we might think of as the “masculine” texts of nineteenth-
century medicine: the body is described meticulously and objectively. The
letter can be quoted in its entirety:
A Case of Conception Without Intromission.

EDS. MED. AND SURGICAL REPORTER:
Mrs. A—, aged nineteen, a native of Ireland, called on me for an examination.
She had menstruated regularly and comfortably until after her marriage, some
three months previously. As coition was out of the question, her condition
seemed to her a mystery. On examination, I found the hymen closing the os
externum.
After a long and diligent search, found a foramen close under the urethra,
where I depressed the hymen half an inch, and introduced a number eleven
bougie, and with my finger in the rectum, succeeded in penetrating a distance
of nearly two inches through the firm, inelastic hymen, when the point plunged
into the vagina. This condition was undoubtedly congenital.
All of her symptoms indicated pregnancy. Dilation was tried without success,
then I operated with director and scalpel.
In six months after, I attended the lady in confinement, which was normal,
and she had a good recovery. In this case the spermatozoa were abandoned in
the depression of the hymen, and traveled through the narrow channel two
inches long into the vagina, and continued their journey to the uterus to fecun-
date the ova.
This fact, with others of the same kind, demonstrate not only the possibility,
but the actual accomplishment of impregnation, where the spermatozoa were
abandoned a long distance from the uterus.
H. E. Longshore, M.D., Philadelphia, Pa
This letter directly violated one of Joseph Longshore’s rules for professional
practice, promulgated in the 1851 valedictory: “Never publish, or consent to
have published, any of your professional acts, however meritorious or laud-
able they may be.” Such publication was for Joseph Longshore a form of
advertisement, a “means of gaining notoriety . . . beneath the dignity of your
position.” 47 Joseph Longshore had been five years dead when Hannah pub-
lished “A Case of Conception Without Intromission,” but her presence in
the text, her bid for “notoriety,” is palpable. The letter is signed, although
the signature does not foreground the writer’s gender. Hannah places herself
in nearly half the sentences of the letter, usually as the subject: I found; I
succeeded; I operated; and I attended the lady. The letter does not tell the
story of a pregnancy but rather tells the story of a doctor investigating
pregnancy.
The topic of pregnancy was actively debated in nineteenth-century medi-
cine in ways that remind us that, although any theory of gender is also a
139
gendered theory, few performances of gender are univocal.48 We might think

that Longshore’s letter, with its foregrounding of the investigator, its relent-
less objectification of the female body, would have been indistinguishable
from essays written by male physicians during this controversy; it followed
the conventions of objective medical reporting of an anatomical case. Han-
nah Longshore presented herself, in her only appearance in print, as the
ultimate phallic physician: she probed, sounded, and ultimately ruptured the
hymen of the patient. Her impassive account of these interventions suggests
that it is not masculinity but science, particularly the scientific ability to trace
anatomical structures, that resolves the “mystery” of conception and opens
the female body.
Received medical opinion, however, held that conception took place only
when the sperm was propelled directly through the cervix; instances of con-
ception without intercourse, therefore, contradicted medical common knowl-
edge. And Hannah Longshore’s impassivity was not at all the rule in writing
on this issue. For many nineteenth-century physicians, impregnation was not
a physiological process like any other but a defining instance of masculinity.
The debate on conception organized unruly energies; it became a matter of
pride, of national identity. In the same issue of the Medical and Surgical
Reporter, the letter of Ohio physician Edward Cass refuted the “European
opinion” that semen is “thrown into the uterine cavity during intercourse.”
Recounting a case similar to Longshore’s, Cass concluded:
Here is a fact—a truth. Here is an accidentally discovered theorem that demon-
strates the possibility that the uterus may be impregnated when the “spermato-
zoa have been abandoned only in the vagina.” The American medical professors,
in their docility to European speculative teachings, are peculiarly credulous.
Since I have made this narrated discovery, I have doubt that the seminal fluid is
almost never thrown into the uterine cavity. . . . It may be that Pallen, Fraer, and
Kolbert, et.al., would take this case to be an exceptional one to the rule, that
the spermatozoa in the Americans are possessed of greater energy to surmount
difficulties than those of other countries—and take into consideration that this
occurred in Ohio, too, where we find the most determined, enterprising, and
aggressive of the race. If this could be copied into every European journal, it
might be a cause for them to reflect, and revolutionize a little speculative
theory.49
Compared with Cass’s triumphant (and self-parodic) story of discovery and

energy, in which the writer identifies overtly with the sperm, Longshore’s
case enforces the clearest of boundaries between subject and object. Al-
though many feminist rhetoricians would describe Longshore’s rhetoric as
masculine, it puts into play a professional performance of gender quite dif-
ferent from Cass’s. Cass writes of impregnation, for example, and Longshore,
of conception. Longshore’s credibility is not ratified by the energy of Ohio
140
sperm or put into the service of an emerging American medicine. Her letter
travesties objectification to cover her own phallic performance and give an
account of reproduction that stands outside of, and by implication against,
masculine triumphalism.
Both Longshore’s speech and her letter to the Philadelphia Medical and
Surgical Reporter speak to our understanding of the relation of gender and
science. Both texts require contextualization in a comprehensive account of
nineteenth-century medical genres, a project that is both long overdue and
beyond the scope of this book. To skim the surface: Nineteenth-century
medical writing included many narrative forms. Both male and female physi-
cians published clinical studies, descriptions of patients and their treat-
ment, presented with varying specificity and narrative presence, usually as
arguments for new forms of treatment, as illustrations of problems with con-
ventional methods, or as puzzling anomalies. Many were “singular” cases,
usually patients with anomalous bodies, especially anomalous reproductive
organs. Mid-nineteenth-century medical journals included a limited number
of empirical studies of physiology, pathology, and the effects of drugs. Those
studies increased in frequency toward the end of the century and included
comparative results of pathological examinations, of experiments, of surveys.
The discourse of health led a vigorous life long after the medical school the-
sis; both inside and outside professional publications, a great deal of physi-
cian’s writing, for both men and women, addressed broad public health is-
sues: How did diseases spread? Which hygienic practices were effective?
How should infants be fed? Should prostitutes be regulated? Then as now,
physicians wrote books of general medical advice and told (often heroic) sto-
ries of medical careers addressed to a general audience; the borders between
these forms and the professional discourse of medicine were much more
permeable than they are now. Nineteenth-century medical writing recalls
Darwin and Freud as much as it anticipates the New England Journal of
Medicine.50
Feminist critics of science have sometimes characterized scientific think-
ing as male in its valuation of dichotomy and hierarchy and opposed it to a
women’s discourse governed by a logic of connection and relationship. In
many feminist theories, science exemplifies masculine objectification; wom-
en’s discursive forms are seen as more fluid and associative.51 This charac-
terization is not fanciful; scientific professions consistently underrepresent
women and have done so from their inception. It would be remarkable if
the discourse of medicine were not gendered male, concerned as it is with
necessarily gendered bodies, elaborated in contexts that were until recently
almost entirely male. But Hannah Longshore’s writing calls this characteriza-
tion of the feminine voice into question. Nothing that she wrote resembles
our understanding of a feminine prose register. And her writing suggests that
141
medicine, as a scientific practice, was not a simple discourse of patriarchy

but one in which women physicians could intervene. This bare presence of
women is significant; Harding has taught us to be generous in assessing the
significance of both the remembered and the forgotten writing by early
women scientists.52 Even the unadorned fact of women’s participation in sci-
entific work subverts its claim to a universalism that is actually masculine.
But women did not simply take up received forms and use them without
elaboration. In Hannah Longshore’s hands, the discourse of masculine ob-
jectification became a way of containing unruly medical discussions of repro-
duction, of making present the specific activity of the female bodies of doctor
and patient. Longshore’s life story also included contradictory and trans-
gressive forms of membership, displaced performances of self-sufficiency.
The subtlety of Longshore’s travesty becomes apparent when we place her
writing in the context of specific genres as they were performed for specific
audiences. Like Ann Preston’s cross-dressed texts, Longshore’s travesties
suggest that as medicine was forming, women were participants in its dis-
courses, articulating a relation to the body and to professional authority that
was quite different from the hegemonic story now told in canonic medical
discourse.
Many stories of illness and cure circulated in the nineteenth century; one
of them survived, in various versions, to become the happy story of modern
medicine, the story of “miracles” touted on Chicago Hope and ER.53 Women
physicians and patients also told other kinds of stories: of generational repeti-
tion, of an obscurely speaking body, of the doctor as repository of family
secrets. We can recover those stories, place them, hear them in some of their
complexity. Ann Preston’s and Hannah Longshore’s versions of these stories
come to us only after interruption. Preston’s enacted the forms of decorous
male scientific discourse with a vengeance; as an institutional writer, she es-
tablished a rhetoric for the Woman’s Medical College that insisted on its
exact congruence with the norms of established, male-dominated institu-
tions. But Longshore appropriated such masculine forms as the autobiogra-
phy or the case study, subverted them to her own rather singular purposes,
and offered them as conventional performances. Her very substantial em-
bodiment as she stood to reply to the toast established her speech as a wom-
an’s appropriation of a genre associated with men. (See figure 10.)
The gender of medical discourse is never simple or binary; and it has al-
ways included women’s voices, whether or not they were pitched in “femi-
nine” tones. Speaking in a form associated with men, speaking to an audience
of women, Longshore used the tropes of distance, objectification, and pro-
fessional success, tropes often seen as masculine, to claim connection and to
express distance, to affiliate with her unnamed family and to assert her stand-
ing as its chief breadwinner. Taking up the genres and speech acts most ex-
142
Figure 10. Hannah E. Longshore, portrait, 1897 (Archives and Special Collections on Women
in Medicine, MCP Hahnemann University)
plicitly associated with masculinity, Longshore enlisted them to speak for the
female body in its singularities, for the woman practitioner and her necessi-
ties. Her challenge, the display of the medicine case, made both the offi-
cious, relenting druggist and the hyper-regular woman physician seem ridic-
ulous. She did not speak as a man; still less, as if she were a man; she acceded
to the definition of science as a particularly male discursive form and then
contradicted that definition by performing “male” science as a woman. Read
as a rhetorical performance, a speech given to a very particular audience,
Longshore’s narrative in all its intertextuality offers a deeply determined rep-
resentation of contradictory social relations. Hers was no polite performance
of affiliation and membership; it was at once an act of aggression, specifically
intellectual and professional aggression, a refusal to tell a feminine story of
life lived in the family, and a symbolic invocation of family relations. Long-
shore’s relatively simple text, therefore, bears the impress of complex per-
sonal, intellectual, and institutional histories; remarkable on its face, it be-
comes more remarkable read in its generic context.
READING INVISIBLE WRITING
What is at stake for us in these stories? Biography, both individual and collec-
tive, has been the site for formulating contemporary feminist theories of sci-
ence from Evelyn Fox Keller to Donna Haraway. Feminist scholars have
engaged in primitive accumulation of the simplest information about women
scientists: they existed; they wrote; they did the work of science. This work,
which one important anthology calls the recovery of “lost and buried women
heroes of science,” is critically important.54
That mission animates Out of the Dead House. I am deeply grateful to the
nineteenth-century women physicians who have given me such a good story
to tell. They are worth remembering, worth celebrating. But, as Evelyn Fox
Keller and Donna Haraway suggest, historical retrieval is not, and should
not be, a pretheoretical enterprise; the celebration of a particular woman
scientist suggests a model for “how some women do science,” or “how
women do science,” or perhaps “how women should do science.” My own
impulse is to argue against essentialism; it is no accident that I have mounted
this argument in a historical study of nineteenth-century medicine, with its
unsettled habitus, focusing on women who varied widely in their scientific
beliefs, politics, and styles of gender performance. These lives speak to me
of the “large liberty” they claimed for themselves and urge that claim anew;
they call into question any unitary understandings of scientific practice or
of gender. The articulation of these two claims—agency and pluralism—
144
offers us an alternative to the same old bad choice between essentialism

and exclusion.
The reader—I and perhaps you—arrives at the text as desiring, specifi-
cally as desiring images of possibility, openings in the texture of what can be
known. The nineteenth-century woman physician, in her different guises,
offers a practice of knowing the body under conditions of extreme gender
differentiation, a practice that acknowledges the social constraints of gender
but refuses to accept them as they have been given to her. She practices a
science that both investigates and preserves the body; medicine sponsors her
deserved reputation for benevolence and her right to see what is normally
forbidden, to go where she would normally be excluded, to know people who
would normally be outside her sphere; in the words of the “Autobiography”:
“A doctor she says is introduced to all phases and conditions of human life
and can learn more of it than those in any occupation.” 55 Both Longshore
and Preston were sustained and preserved by their profession; they felt that
they had been saved from lives of marginal inconsequence. I have no de-
fenses against such a story.
Just as the woman scientist’s choice to write about medicine is not inno-
cent, neither is my choice to write about women scientists (rather than their
patients, or nurses, or women who hated scientists). Such writing inscribes
a wish that scientific practice, an expert and differentiated system, could
become more porous and accessible; it enacts a desire to cut through the
knotty questions posed by identity politics without painfully working through
them—wishes and desires that could become parasitic on the lives of the
nineteenth-century women physicians, reducing them (yet again) to the sta-
tus of edifying examples. Such a project itself necessarily risks travesty, taking
up heroic figures as disguises that authorize ideas that they would have found
transgressive. I approach these texts with desires to disclose a surprising past
and to reconstruct a usable past. I want to remember them, to place them
among the crowded nineteenth-century pantheon of tireless women writers;
I also want them to speak to us, to make our work less inevitable in its trajec-
tories, less enclosed in the boundaries that our choices and theirs have cre-
ated. This Hannah, my Hannah, probing and gesturing, standing in the light-
ning or falling asleep in her chair, offers us an image of scientific practice
that is no longer possible to us. But it is for us, reading these quotidian and
singular texts, to reflect on our own implication in projects of recovery and
reconstruction—and on our strategies for joining or distancing ourselves
from them.
145
6
Mary Putnam Jacobi

Medicine as Will and Idea
My interest in contemplation persisted, and even increased, but I acquired an increasing
reluctance to effort and voluntary mental exertion. I appreciated Schopenhauer’s “Con-
demnation of the Will,” and felt confirmed in my view that his entire theory sprang from a
deep inner consciousness of personal weakness of volition.
This impressed me the more from its sharp contrast with the vivacity and strength of
volition which had been a leading characteristic with me all my life.
—Mary Putnam Jacobi, “Description of the Early Symptoms of the Meningeal Tumor
Compressing the Cerebellum. From Which the Writer Died. Written by Herself”
“Description of Early Symptoms of the Meningeal Tumor” was a self-

report of Mary Putnam Jacobi’s final illness, circulated to her physician
friends to confirm that her case was not treatable.1 Nothing less than a brain
tumor brought Mary Putnam Jacobi (1842–1906) to the limits of her will; to
her, only a terminal illness could have explained an unwillingness to plan and
project. Unlike Ann Preston or Hannah Longshore, Mary Putnam Jacobi
inhabited a world close to ours, but the life she lived, vividly expressed in
her writing, is not one we can easily imagine. The medicine that she studied
and practiced was a mature science, and she wrote medical texts that are
recognizable as scientific discourse; they are located within disciplinary con-
troversies, discuss issues that have been constructed during those controver-
sies, and foreground relatively modern methods of drawing conclusions from
evidence. True, we do find her, as a medical student in Paris, repeating con-
ventional refutations of Lister and refusing to admit the specificity of Bright’s
disease.2 But she would never write—we could never imagine her writing—
like Ann Preston, who commiserated with a friend upset by a visit to the
Woman’s Medical College dissecting room: “How glad I am that thee had
Chandler to mesmerize and soothe thee.” 3 Still less can we imagine Putnam
Jacobi, a lifelong positivist, dispensing homeopathic remedies from a satchel
or attending meetings of the spiritualist Harmonial Circle. Homeopath was
for her a lifelong term of contempt.
146
Mary Putnam Jacobi
Even in bare outline, Mary Putnam Jacobi’s life speaks of her energy, deci-
sion, discursive force. She invented her own medical education, traveled to
Union-occupied New Orleans during the Civil War, remained in Paris during
the Commune, and married a German Jewish physician who had been pros-
ecuted in the Cologne Communist trial and would later become the founder
of American pediatrics. She carried on a thriving practice, treating C. P. Gil-
man for neurasthenia. She taught medicine and published some 149 articles
on medical topics, besides fiction in her youth and political writings at inter-
vals throughout her career. She won the prestigious Boylston Prize for Medi-
cal Writing from Harvard in 1876 for her Question of Rest for Women during
Menstruation, a refutation of George Clarke’s dire warnings against educat-
ing women.4 If Ann Preston and Hannah Longshore ventured into territories
of language closed to women, Mary Putnam Jacobi laid claim to vast tracts
of forbidden ground: menstruation, hysteria, nervous disease, the interior of
the uterus. Other nineteenth-century women physicians were active scien-
tists or prolific popular writers; few combined both genres, and none as pro-
ductively as Mary Putnam Jacobi.
If Ann Preston’s strategy for managing the gender of scientific writing was
a marked and nontransgressive cross-dressing, and if Hannah Longshore’s
gender strategy can be described as travesty, then Mary Putnam Jacobi’s
writing is a series of experiments in gender performance. She attempted, at
different points in her career, all the available styles for enacting the oxy-
moron woman doctor. Sometimes her performance insisted on her gender;
other times, she emphasized traits that, for a nineteenth-century audience,
were strongly marked as male: cool-headed courage under fire, readiness in
emergencies.5 Putnam Jacobi also wrote anonymously, sometimes in contexts
which would lead her audience to read her writing as that of a male; this
rhetorical cross-dressing is unmarked, since its quality as performance was
lost on the original audience. In her student years, she often elided her gen-
der, writing anonymously and only occasionally, although always provoca-
tively, examining gender in her writing. Later, she would experiment with
various styles of gender performance: she collaborated with her husband,
Abraham Jacobi, blurring the gender of the author. Her medical texts are
insistent in their regularity and scientific rigor, and very often gender is sa-
lient in them; Putnam Jacobi could pretend to write as a male, using that
pretense subversively. Like Preston and Longshore, she presented her writ-
ing of medicine as totally compliant and conventional; however, she was both
rigorously attentive to what counted as a medical proof and creative in devis-
ing new means of argument. Rhetorically, Putnam Jacobi was virtually im-
mune to the sentimentalism that was characteristic of nineteenth-century
northeastern progressive circles.6 Her distinctive voice—dry, self-aware, an-
alytic, sometimes passionate—is audible from her first writings. Her first
147
Mary Putnam Jacobi
publication was an adolescent short story, “Found and Lost.” 7 The narrator
is a physician who has settled down to read next to a corpse on a dark and
stormy night. Not many sixteen-year-old girls, now or then, imagine a physi-
cian’s life as a chance to stay up late, reading cozily next to a dead body.
TELLING A MEDICAL LIFE
Putnam Jacobi’s writings include an autobiographical manuscript in the

Schlesinger Library, Radcliffe College, dated 1902 and privately circulated.8
This sketch seems to have been Ruth Putnam’s source for most of the infor-
mation about Putnam Jacobi’s early life in her Life and Letters of Mary Put-
nam Jacobi, the standard biography. Putnam Jacobi’s autobiography is cog-
nate to Hannah Longshore’s toast: late in her life, she decided to tell a
version of her story. Putnam Jacobi’s is a story of childhood, of childhood
regrets and childhood triumphs. The very young Mary Corrine Putnam tor-
mented a sickly fellow passenger on her voyage from England to America by
dangling her doll out the window into the waves. A slightly older Mary Put-
nam refused to believe her cousin’s warning that she was out of her depth
in the Long Island Sound and thought as she sank, “Tomorrow I shall be
thrown up on the shore just like the drowned kittens that are always being
thrown up here.” 9 The nine-year-old Mary found a dead rat in the stable and
planned to dissect it to find the heart, which she “greatly longed to see.” 10
Her nerve failed her; she told her mother about her plan and was relieved
when she was forbidden to touch the rat. She proved her desire for social
reform by sliding in the snow “belly guts” instead of sitting up like the other
girls. When she was twelve and the family had moved to Yonkers, Mary
walked ten miles on nutting expeditions or climbed twenty feet up the Cro-
ton Aqueduct and sat high on a ledge, playing cards.
After her father, founder of Putnam’s publishing house, went bankrupt in
1857, Putnam Jacobi’s haphazard education suddenly became serious be-
cause she would have to support herself. The family moved to New York
City, and Mary entered a public school. Mary Putnam, as she told her story,
was a girl unwilling to take anything on faith or to bow to custom, a girl
suffused with strength and vitality if not wisdom or generosity, an inquirer
rather than an intellectual. That is not the only story Mary Putnam Jacobi
could have told. Her correspondence shows vexing religious doubt and tur-
moil in the early teens; her letters to her grandmother are filled with a sense
of sin and loss, and she continued as a church member until she was twenty-
one.11 On her twelfth birthday, she wrote a note mourning that “I am not
two years younger, so I need not enter the artificial world which the stupid
ingenuity of man has created.” 12 Later, Mary and her family fought an ongo-
148
Mary Putnam Jacobi
ing war of position about her medical career and future prospects, although
her family had introduced Mary to the Blackwell sisters and admired them.13
Both Mary Putnam’s father and her mother, however, doubted the wisdom
of her following a medical career.14 When she began her medical studies in
Paris, Mary Putnam thanked her father for the “large liberty” he had always
left her; that liberty was not constructed without the labor of both father
and daughter.15
As a writer, Mary Putnam Jacobi helped to shape the emerging discourse
of scientific medicine at the end of the nineteenth century. She published in
the full range of medical genres: While she taught materia medica at the
Blackwells’ school, the Woman’s Medical College of the New York Infirmary,
she published articles on specific drugs and their activity. She gave a total of
fifty-nine presentations to the New York Pathological Society and was also
active in the New York County Medical Society, the Medical Library and
Journal Association of New York, the Neurological Society, the Therapeutic
Society, and the Academy of Sciences. In 1900, she was seeking admission to
the Obstetrical Society of New York. She attended meetings of the alumnae
association of the Woman’s Medical College, insisting that they include pre-
sentations of medical papers; she served as its president from 1888 to 1891
and again in 1894–95.16 These presentations were written up and reported,
as was customary, in the active medical press; the proceedings of the New
York Pathological Society were regularly reported in the Medical Record,
including the twenty-eight presentations Mary Putnam gave during the
1880s and the subsequent discussion.
Nor did Mary Putnam Jacobi limit her research to conventional genres.
She was avidly interested in the technologies developing in the 1880s and
1890s for tracing bodily functions, devising experiments in which they could
be used and publishing her findings. Putnam Jacobi collated and recorded
the results of therapeutic interventions, often using the patient populations
at the New York Infirmary for Women and Children or those of Mount Sinai,
where she had established a children’s dispensary and pediatric ward in the
style of French clinical medicine. She also used information gathered from
patients in a survey—a device that was not at all in the French clinical style.
Putnam Jacobi wrote thirteen articles on therapies during the 1880s and
1890s, reporting on the results of cold baths, surgical drains, electricity, and,
in one of her last-published essays, hypnotism. Especially after her career
was established, Putnam Jacobi wrote on women’s rights, including essays on
the right to medical education, producing (like Ann Preston) the usual round
of inaugural and commencement addresses and also bracing essays on politi-
cal topics for the Medical Record. She addressed the New York State Consti-
tutional Convention on woman’s suffrage and wrote a long chapter entitled
“Women in Medicine” for a volume on women’s work in America.17 Because
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Mary Putnam Jacobi
of the Boylston Prize essay, Mary Putnam Jacobi is remembered for her work
in gynecology; those studies began with clinical investigations of the effects
of treating anemia with cold water and massage and culminated in a series
of essays on hysteria, both published in book form.18
In sheer volume and range, Putnam Jacobi’s work is more substantial,
more central to her profession, and more sustained than that of any other
nineteenth-century woman physician. And nineteenth-century women phy-
sicians could be active writers. Elizabeth Blackwell wrote a number of books,
most of them intended for popular audiences, but was generally silent on
medical controversies as medical writers debated them.19 Other graduates of
the Woman’s Medical College wrote regularly, but none published in so
many medical genres or sustained their writing over thirty years.20
Putnam Jacobi enjoyed a distinguished reputation. Just as Ann Preston
exemplified the self-effacing and dignified woman physician, just as Hannah
Longshore was captured by her husband as a saint of science, Mary Put-
nam Jacobi was, for regular physicians, the exceptional example; she proved
that a woman physician, if sufficiently scientific and regular, could succeed.
Presentations that she gave in the 1890s were received with enthusiasm. In
1892, after she read her paper “Urethral Irritation” to the Philadelphia
County Medical Society, a group legendary for its hostility to women, discus-
sants vied with each other to praise it. The first respondent, Dr. Frederick P.
Henry, had agreed to speak, not only because it was an honor to reply to Dr.
Putnam Jacobi, but also because, as he explained, “I felt confident that the
subject would be so exhaustively treated that my part in the matter would
be simply nominal.” Dr. Henry’s praise was seconded by Dr. Tyson, who
could “add nothing to what has already been said,” and by Dr. Roberts, who
held that “a paper of this importance should not be allowed to fall entirely
into the hands of the specialists.” 21
How did Mary Putnam learn to write, and especially to write medicine?
What intellectual problems did she address, and what tools did she bring to
bear on them? And finally, how did this writer perform gender (or refuse to
perform it) in her medical writing?
APPRENTICESHIP OF A WRITER
Mary Putnam attended the New York College of Pharmacy in 1861; her fa-
ther had requested that she suspend any plans for medical studies away from
home for two years.22 Putnam Jacobi planned to attend the Woman’s Medical
College of Philadelphia after graduating from the pharmacy school, but in
1862 she traveled to New Orleans, then occupied by the Union Army, to
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Mary Putnam Jacobi
nurse her brother, Haven; years later, Haven told of her preaching “right
powerful” at a service for escaped slaves.23
In 1863, Mary Putnam traveled to the Woman’s Medical College of Penn-
sylvania. Her arrival may well have seemed a mixed blessing to the faculty:
she was a brilliant and hard-working, but incorrigibly unprocedural, student.
Unlike those young women who extended their studies for up to three years,
hearing the same lectures each year, Mary Putnam felt quite ready to gradu-
ate after one round. When asked to supply evidence of two years of study,
she proffered lecture tickets from the New York College of Pharmacy. Her
thesis, a Latin discussion of the spleen,24 seems to have taxed the faculty’s
classicism; Professor Coates agreed to read it on February 3, 1864, but no
report from him was available when they next met. In response to faculty
requests, Mary Putnam offered assorted additional lecture tickets but admit-
ted that she had stopped attending some of the weaker College of Pharmacy
lectures and that her tickets for the course in the practice of medicine were
just plain lost. In fact, she had never been matriculated at the College of
Pharmacy. The faculty were not pleased with Putnam’s casual attitude to-
ward academic procedure, but Ann Preston moved to admit her to examina-
tion on the grounds that she had studied medicine for three years and com-
pleted the other requirements. Coates finally read half of Putnam’s thesis
and reported that it “seemed to be a fair expose of what is at present known
concerning the spleen and to be of satisfactory latinity though containing
some errors of grammatical construction.” 25 Inquiries to Elizabeth Blackwell
and to the dean of the New York Medical College were pronounced incon-
clusive; after weeks of debate, Mary Putnam was admitted to examinations.
Dean Edwin Fussell resigned in protest after her graduation, convinced that
Putnam had deceived the faculty and that their standards had been fatally
relaxed. Ann Preston succeeded him, becoming the first woman dean of any
medical school.26
Mary Putnam was as dissatisfied with her education as her teachers had
been with her. Connected throughout much of her professional career with
the Blackwell sisters’ institution, the Woman’s Medical College of the New
York Infirmary, she seldom spoke about her early experiences at the Phila-
delphia school outside its alumnae association. But thirty years later, in her
essay “Woman in Medicine” for Annie Nathan Meyer’s collection Woman’s
Work in America, she characterized the school’s “knowledge and pecuniary
resources” as “both inadequate,” with “rambling lectures, given by gentle-
men of good intentions but imperfect fitness, to women whose previous edu-
cation left them utterly unprepared to enter a learned profession, and many
of whom were really, and in the ordinary sense, illiterate.” 27 She quoted with-
out dispute Elizabeth Blackwell’s opinion that the physicians graduated by
women’s colleges before 1859 were inadequately trained, and she character-
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Mary Putnam Jacobi
ized Preston, ungenerously, as one who believed that “if the moral behavior
of the new physicians were kept irreproachable, intellectual difficulties
would take care of themselves, or be solved by an over-ruling Providence.” 28
In the story of women’s medical education that Putnam Jacobi wrote in 1891,
the Woman’s Medical College of Pennsylvania was the problem; the Wom-
an’s Medical College of the New York Infirmary, her own institution, was
the solution.
After graduation Mary cast about, even proposing to manage the Putnam
family housekeeping “on scientific principles.” 29 She established a small
practice, studied chemistry, and traveled to Port Royal, South Carolina, to
nurse her ailing sister Edith, a Reconstruction teacher. She was briefly en-
gaged to her chemistry teacher, Professor Mayer. Her mother announced
the engagement with some surprise to a family friend and also reported that
“Minnie” did not enjoy the practice of medicine but was absorbed in chemi-
cal study; “Dr. Putnam is laid upon the shelf.” 30 She broke off the engage-
ment and returned to New Orleans to earn money as a tutor. With those
savings, she traveled to France, arriving in 1866, at the age of twenty-two.
Although Mary had published some short stories during her teens and had
published regular correspondence from New Orleans, it was in Paris that
she began to write on medical subjects for medical audiences, to take up
serious political issues, and to write compelling fiction. Mary Putnam wrote
to gather information, shape for herself a professional register, and earn a
living. She produced regular columns for the New York Evening Post and
the New Orleans Sunday Times; she summarized French medical news for
the New York Medical Record.31 The columns for the Evening Post and the
Sunday Times, on such topics as the new Parisian bonbon boxes, were simply
a source of income, but the Medical Record correspondence was substantial
and extended; it led to a lifelong association with the journal and provided
the twenty-two-year-old medical student with sustained practice in the writ-
ing of medicine, a practice facilitated by anonymity.32
When problems developed with her newspaper correspondence, Mary
Putnam looked for other literary work. She needed the money. Her father
invited her to submit something to the new Putnam’s Monthly, and her let-
ters in 1867 outline a dizzying range of writing projects: a scientific account
of the miracles of the Bible; a critique of Tuckerman’s popular guide to Paris;
an essay on pain; a brochure on facial expression as a means of diagnosis;33 pop-
ular scientific articles; essays on the French intellect, on proof, on the duties
of intellectuals; a romance; a translation for the Putnam’s series of “railroad
books”;34 and an essay on heaven as pure thought, conceived as a refutation
of Elizabeth Stuart Phelps’s resolutely material paradise, The Gates Ajar.35
What Mary Putnam actually wrote was both more and less interesting: essays
entitled “Imagination and Language” and “A Study of Still-Life, Paris,” pub-
152
Mary Putnam Jacobi
lished in Putnam’s Monthly; the short stories “A Sermon at Notre-Dame,” “A

Martyr to Science,” and the novella Concerning Charlotte, also published in
Putnam’s Monthly; and two political sketches, extracts from an unfinished
account of the siege of Paris and the Commune, “The Clubs of Paris” and
“Some of the French Leaders,” both published in Scribner’s Monthly.36 Put-
nam therefore wrote, during her five years in Paris, some 170 pages of medi-
cal journalism, 300 pages of essays, stories, and commentary, and an undeter-
mined amount of popular journalism, while maintaining an active family
correspondence. Even by the standards of the overachieving nineteenth cen-
tury, this is a lot of writing. Mary Putnam established the cadences of her
medical style and invented the logical figures that would shape her writing.
In one of her family letters from Paris, Mary Putnam described herself as
“quite innocent of grace, but expressing a certain force and vitality . . . ; with
no pretensions to dignity, but not deficient, I believe, in self possession and
repose.” 37 (See figure 11.) Except for repose (nobody ever described her as
quiet), these adjectives characterize Mary Putnam’s prose quite aptly.
We might begin with her letters, records of a vivid mind, disposed to learn
everything, encountering with exhilaration a metropolitan culture. Putnam
studied French, immersed herself in art, and walked all over Paris. She made
what arrangements she could for medical study but wavered, in those first
months, between medicine and chemistry, settling on medicine so that she
could earn her own living. She found that she suddenly had “the most vivid
admiration for dress.” 38 After she had arranged for admission to hospitals
and clinics, she embarked on a daily routine (at least as far as her letters
home were concerned) that began with two hours of reading at five o’clock
in the morning. Then she might walk to the Lariboisière hospital or to one
of the others to which she was admitted, including the Salpêtrière, a hospital
for the insane. She would hear lectures, attend an autopsy, have breakfast,
hear a histology lecture, work in the microscope lab, and write a letter to the
New York Evening Post. At night, finished with her work, she would walk to
the Madeleine, “whence one could look down to the Rue Royale lined by a
hundred lamps, to the obelisk of Luxor on the Place de Concorde, and up,
among the beautiful columns that supported the roof, to the perfectly stain-
less summer sky.” “Some day,” she wrote to her sister Edith, “we must stand
together on that porch.” 39
Later, after a long struggle, she gained admittance to the École de Méde-
cine. She attended its clinics and lectures and put herself into training for
the series of four oral examinations which she faced (her Woman’s Medical
College degree had exempted her from the first three exams in the degree
program). And she became friendly with a group of “real French reformers
and red-hot republicans” 40 centered on the Réclus family. Mary, who could
be prudish about student balls and masquerades (especially in letters to her
153
Figure 11. Mary Putnam Jacobi, 1860–65 (The Schlesinger Library, Radcliffe College)
Mary Putnam Jacobi
worried mother), was palpably surprised when Mme. Réclus herself left to
wash up the dishes after a dinner party, but found this circle “strange and
fresh and vivid.” 41
In Paris, then, while continuing her connection to the Blackwells, Mary
Putnam worked in settings remote from the middle-class literary and reform
circles she was accustomed to; she made her way into social settings which
required new strategies for the performance of gender: the relentlessly male
world of the medical schools and hospitals, and the plebeian, experimental
social relations of anarchist circles. The stories that Mary Putnam wrote dur-
ing this period, almost against her better judgment, investigate precisely the
issues of gender performance and of female agency that would be central to
her medical writing. Consumed by a dread “of becoming a ‘literary physi-
cian,’” she asked her parents to keep her authorship of the stories secret, not
to mention her writing “to anybody.” 42 And although Putnam circulated
drafts to some Parisian friends, she felt that it would damage her reputation
as a serious student to be known as the writer of such frivolities; above all,
she did not want her friends “dissecting” them to see whether they were
about her life.43 After she began medical practice, she renounced any further
literary work. (Silas Weir Mitchell followed Oliver Wendell Holmes’s advice
and delayed literary publication until he was established as a physician; the
mere figure of Holmes was sufficiently monitory to end Putnam’s literary
career.44 ) These essays work seriously at the problem of what it meant to be
a politically engaged and scientifically absorbed nineteenth-century woman,
a problem that Putnam continued to encounter and resolve provisionally
throughout her career. Sometimes her solution was a version of professional
cross-dressing. In her “Study of Still-Life, Paris,” originally published in Put-
nam’s Monthly, Putnam described the public reading room where she stud-
ied medicine before she was admitted to the library of the École de Méde-
cine. We see the room, and we look from its windows into the street, but we
are not told what it was like to be a woman occupying that space, perhaps
the only woman in it. The decision to elide her gender was implied in the
decision to write anonymously; Mary Putnam could no more have published
an anonymous account of her experience as a woman medical student in
Paris than Chelsea Clinton could write anonymously as someone who had
lived in the White House as a teenager.
A quite different performance of the scientific persona is offered in “A
Martyr to Science,” narrated by a fanatic physician who has devoted his life
to preparing for his own vivisection so that his beating heart can be studied.
The incision would be made over several days with caustics, and doses of
woorara (a drug which always fascinated Putnam Jacobi) would allow the
motion of the normal heartbeat to be studied for the first time.45 The narra-
tor trained an apprentice for precisely this grisly task. Putnam showed an
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Mary Putnam Jacobi
early draft of the story to M. Réclus, who declared it “impossible”; she re-
wrote, consigning the narrator to Charenton. Another reader urged her to
rewrite the ending “with a scalpel”; she lost patience and sent it out as it
was.46 Putnam had read her Edgar Allen Poe, and “A Martyr to Science”
connects his gruesome fantasies to the intense, very widespread desire of
scientifically inclined nineteenth-century Americans to see the interior of
the living body. We might remember—and we will remember again, in the
next chapter—the old Mary Putnam Jacobi’s story of the young Mary Put-
nam’s great desire to find the heart of the dead rat. The narrator of “A Martyr
to Science” occupies the full range of gender positions; he is absorbed in
speculation, a being beyond gender whose “mind becomes hopelessly fasci-
nated, and continues to pirouette about an invisible point, that is neither a
thought nor a material phenomenon.” 47 He is consumed by masculine activ-
ity as he advances his career in Paris, and he identifies with a feminized
subject as he fantasizes his own luxuriously passive dissection. This vagrant
gender performance is stabilized, for a time, when the narrator and his pupil
Guy begin their collaboration, a project which is homoerotically charged:
“You love me then, Guy?”

“Love you!” He rose from the table, and coming to the sofa, kneeled and
kissed my forehead without shame, as in France men can kiss each other.
“My master, my friend!” he said; and I felt that he was mine, bound to me by
a love passing the love of women. I drew him before me, and ran my fingers
through his clustering hair.48
But this stability is not secure; in a moment, the narrator dismisses his af-
fection for Guy as “a feminine desire” and puts his experiment in train. In
“A Martyr to Science,” Mary Putnam connected the desire to see the interior
of the body with both masculine ambition and feminine desire to be seen,
organizing those desires in two bodies of the same sex.
A similar strategy marks the longest of these early stories, Concerning
Charlotte. The novella is extremely episodic, as befits a story published in
installments and never meant for consecutive reading. In the most remark-
able and transgressive episode in the story, Charlotte, a passionate heiress,
impersonates her rival, Margaret, the reserved, virtuous, and mistreated gov-
erness beloved by a magnanimous republican refugee named Ethelbert.
Charlotte longed to “intercept the one pleasure of Ethelbert’s first words,
and drain their sweetness, even though nothing but husks should be left for
the person for whom they were intended”;49 she disguised herself as Marga-
ret at (of course) a masquerade.
Concerning Charlotte investigates, again, the desire to see a living, beat-
ing, human heart: Charlotte, like Guy, wants to see what should not be seen
and herself remain invisible. Margaret, understandably, is not mollified by
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Mary Putnam Jacobi
Charlotte’s protest that she has faithfully reported Ethelbert’s declaration,

and her indignation leaves Charlotte feeling “miserably small and inade-
quate.” 50 Charlotte resorts to the time-honored romantic strategies of renun-
ciation, political adventure, and erotic triumph. She undertakes a dangerous
mission for Ethelbert, returns in triumph, and an indeterminate passion
sweeps them both away. This story, ostensibly remote from any medical is-
sue, is also a representation of the gender choices arrayed before the young
Mary Putnam. The virtuous and boring Margaret offers one version of the
habitus of the female physician: the impersonal, benevolent reserve exempli-
fied, in different ways, by Elizabeth Blackwell and Ann Preston. Charlotte’s
willingness to risk action, to stake her life on the republican cause, offers
another version of a feminine medical habitus, one that might remind us of
the young Zakrzewska setting off for North America after she heard that
there women were allowed to become doctors. Charlotte’s desire to enact
her philosophical commitments—she runs a school on Rousseau’s prin-
ciples—recalls Putnam Jacobi’s own explanation of the particular attraction
of medicine: its close connection between theoretical knowledge and practi-
cal activity:
Hence in the most abstract reasoning—if the physician be capable of such—he

must always keep his mind intently focused upon the practical purpose toward
which it must converge. . . . He must see that his antiseptic fluids actually reach
the infected surfaces; he must see that his hot baths are of a given temperature,
and that his cold applications are renewed as often as they grow warm; he must
know whether the medicine prescribed has been vomited, whether the food has
been given at the stated intervals, whether the pulse has responded to the
stimulant.51
What drew Putnam Jacobi to medicine, what held her in medical practice,
teaching, and research, was the possibility of simultaneously engaging dif-
ficult intellectual problems and acting on the most quotidian level of the
real; it was exactly this conjuncture that nineteenth-century culture found
very difficult to gender as female, preferring to contain female agency as
housekeeping, hygiene, prevention. The problem Putnam faced as a young
student—and by 1880, she had not entirely solved it—was that of imagining
such activity performed by a woman who was recognizably feminine. Much
later, in 1895, Mary Putnam Jacobi would write, “Too much attention is paid
to women as objects, while yet they remain in too many cases insufficiently
prepared to act as independent subjects.” 52 Mary Putnam’s fiction rings the
changes on women as objects and as subjects, as self-forming, active, and
independent subjects; these issues are particularly pressing in Concerning
Charlotte. Charlotte, who has no trouble acting as a subject or having ideas,
who can be erotic or appetitive, is also dauntingly amoral, damaging, and
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Mary Putnam Jacobi
cruel to Margaret. Charlotte and Margaret split the representational work of

agency: Charlotte offers activity; Margaret, responsibility and self-possession.
Mary Putnam was not alone in organizing the dichotomy between agency
and feminine subjectivity in a pair of split characters. Many nineteenth-
century images of the medical woman organize all the benevolence and pro-
priety in one character and all the pleasure and action in the other, as if it
were impossible to imagine a female character “prepared to act as indepen-
dent subject” without unchecked narcissism. Charles Reade’s The Woman-
Hater, a novel that mentions “Miss Mary Putnam at Paris,” includes both the
active and eccentric Rhoda Gale and the passionate, womanly Ina.53 Rhoda’s
obsession with Ina, like Charlotte’s with Margaret, is presented as a desire
to merge with a passivity seen as both deeply attractive and intrinsically femi-
nine. Underneath the sanctioned ideological fantasy of the good woman (ma-
ternal, energetic, and prudent) was the dream of passive indulgence (Ann
Preston’s fantasy of plentiful strawberries and a drifting boat). For medical
women and those who wrote about them, horror could invest either the pole
of prudent activity or that of passive repose; images of cranks, of destructive
enthusiasms, alternate with nightmares of parasitic invalidism and depen-
dency. The middle ground, an agency that allowed itself periodic repose,
seemed uninhabitable, attainable only through borrowing, disguise, and sub-
version. Throughout her time in Paris, Mary Putnam experimented with
these strategies, combining them in new ways, testing their limits.
Although Mary Putnam published her short stories anonymously to pre-
serve her professional credibility, her letters on French medicine for the
Medical Record, equally anonymous, would have been proof against more
damning evidence of frivolity. Signed “P. C. M.,” a reversal of her initials,
they offer a detailed and circumstantial account of French medicine—its
institutions, public events, clinical practices, and lines of research. These let-
ters, written weekly from June 1867 to July 1869, each running about five
thousand words, were her apprenticeship as a medical writer. In topic, style,
and attitude, they were modeled on the correspondence in French medical
gazettes.54 Through them, we follow Mary Putnam’s circulation through the
French hospital system; we see such events as the elections to the academy,
the opening of the academic year, the sessions of the International Medical
Congress, the elections of interns. Mary Putnam reported these ceremonies
with a skeptical eye; before the congress opened, she expected great things,
but after attending its sessions, she wrote that it was “ill-organized, the pro-
gramme arranged without sufficient tact, and the legitimate aims of the dis-
cussions almost entirely lost sight of.” 55 She was particularly disappointed
that neither Virchow nor Graefe spoke. Covered by the veil of anonymity,
she took positions that would have been difficult for a woman medical stu-
dent to defend publicly: she was sympathetic to the public registration and
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Mary Putnam Jacobi
examination of prostitutes; she described the experiments performed on the

bodies of criminals immediately after their executions.56 When she gained
admission to a surgical clinic, her letters were all of operations; when she
studied skin diseases, she celebrated the wards of the Hôpital St. Louis,
where “the most repulsive forms of disease . . . are stripped of a large share
of their deformity.” 57 These letters give us a young woman in the middle of
the nineteenth century learning to write a medicine more advanced than that
available to women in the United States. They repay close study and analysis.
We might begin by placing a paragraph of Mary Putnam’s against cognate
passages written by men and women medical students in Philadelphia, stu-
dents at a comparable level of medical education—the writers of the theses
analyzed in chapter 4. Tuberculosis, or phthisis, sadly enough required fre-
quent discussion, both in medical school theses and in Mary Putnam’s corre-
spondence. In her account of the International Medical Congress, Putnam
summarized one phase of the discussion of tuberculosis, a controversy on the
specificity of the disease. Everyone at the congress thought that tubercles
themselves displayed no anatomical specificity, but various theories about
the secretions of the tubercle as defining the phthisis were advanced. Put-
nam briefly summarized several talks, concluding:
In the granulations, these leucocytes are distinguished by pus, chiefly by the
absence of intercellular substance; are small, because bathed by no liquid, and
have only a single nucleus, on account of their low vitality. These leucocytes
arise from the epithelial cells, or those of the connective tissue, and submit ulti-
mately to fatty degenerations, etc.58
Let us compare, first, a passage from Margaret Richardson’s 1852 thesis, “A

Disquisition on Phthisis Pulmonalis,” which also takes up the question of the
“specificity of the tubercular deposit”:
But in a truly genuine pulmonary affection, tubercles, more or less numerous
present themselves in some of their varied forms and stages. In some parts of
the lungs, very minute particles, scarcely distinguishable by the naked eye, are
discovered while in other parts, larger bodies, varying in size form and colour,
are scattered throughout their structure. Other appearances also present them-
selves. Abscesses of various sizes and secreting a brownish or blackish pus, are
more or less numerous and denote the advanced stage of the disease. Carti-
laginous bodies indicating the cicatrization of the ulcerous cavities are also
manifest.59
And we can read a passage on the same topic in John Sale’s 1850 University
of Pennsylvania thesis, “An Essay on Haemoptysis”:
The appearance of the mucous membrane upon dissection is various, sometimes
red, and congested, and all the appearances of inflammation, in others exactly
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Mary Putnam Jacobi
the opposite pale, and transparent, Bichat although examining carefully with the
microscope the mucous membrane of those dying of this disease, could never
discover the slightest erosion, from his and numberless other investigations,
death is supposed to occur from exhalation from the mucous membrane—The
blood issuing from a small breach, too small to be perceived, may sometimes
produce death.60
Some of the differences in these accounts are the results of the nearly twenty
years of research between the writing of the theses in the 1850s and Putnam’s
1867 letter. All three accounts are marked by close, detailed descriptions of
tissues, but they differ in their use of mediating tools. Mary Putnam summa-
rizes what various speakers said they saw through a microscope. Both Richard-
son and Sale would have had access to microscopes, and Sale reports Bichat’s
microscopic discoveries, but these tools were not in routine use in the 1850s;
the chair of microscopy was not established at the University of Pennsylvania
until 1869 or at the Woman’s Medical College until 1872.61 The apparatus sup-
ports Putnam’s talk of leucocytes, intercellular substances, and cellular nuclei;
for her, the cell is salient, just as the tissue was salient to Richardson and Sale.
But not all the differences in these passages are accounted for by develop-
ments in technology. Putnam’s argument is framed by the rhetorical exigency
of reporting on the International Medical Congress. Her description of the
tubercles turns on details that had already been deployed to support the
congress’s arguments about phthisis. Putnam arranges them to support her
own claim that “tuberculization is by no means a specific disease . . . but an
affection of the same order as inflammations.” 62 But for both Richardson
and Sale, tissue, closely described, tells the story of the patient’s illness. No
specifically medical argument mediates between the details in their theses
(particles, pus, and scarring) and the disease processes they account for. In
the student theses, the body speaks directly to medicine; in Mary Putnam’s
medical letters, specific doctors speak about medicine through their descrip-
tions of the body.
This difference can be illustrated by analogy to the conventions of land-
scape description, a common source for tropes and schemes of anatomy.63
These passages recall the quite different landscapes described by Sir Walter
Scott and by Ralph Waldo Emerson—two perennial favorites in American
reform circles. In the Waverly novels, detailed representations of nature
serve as representations of the hero’s experience; the landscape rearranges
the narrative, offers it to the reader at a glance:
In one place a crag of huge size presented its gigantic bulk, as if to forbid the
passenger’s farther progress; and it was not until he approached its very base,
that Waverly discerned the sudden and acute turn by which the pathway
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Mary Putnam Jacobi
wheeled its course around this formidable obstacle. In another spot, the proj-
ecting rocks from the opposite side of the chasm had approached so near to each
other, that two pine-trees laid across, and covered with turf, formed a rustic
bridge at the height of at least one hundred and fifty feet.64
Scott’s description of the landscape resembles Richardson’s and Sale’s de-

scriptions of tissues: intense attention to proximity and contiguity, precise
accounts of size, conformation, and the relations of objects. The landscape
is organized by the path the hero takes through it; crags, chasms, and trees
suggest his route, so that the landscape suggests a narrative. Richardson’s
and Sale’s descriptions of tissues also support narratives: for Richardson, the
progress of the disease; for Sale, the source of the hemorrhage.
Putnam’s descriptions, however, recall the Emerson of “Nature”:
My house stands in low land, with limited outlook, and on the skirt of the
village. But I go with my friend to the shore of our little river, and with one
stroke of the paddle, I leave the village politics and personalities, yes, and the
world of villages and personalities behind, and pass into a delicate realm of sun-
set and moonlight, too bright almost for spotted man to enter without noviciate
and probation.65
The landscape does not promise adventures; it demands a reader who has
learned how to enter it—an education supplied, among other things, by
reading Emerson. Mary Putnam’s letters record a similar education, a trans-
formation of symptoms and signs into arguments and controversies, medical
conversations for which her own texts will be an adequate “noviciate and
probation” for both reader and writer.
In discussing mid-nineteenth-century medical school theses, I argued that
they were organized in two registers: a register of medicine and a register of
health. They discussed what doctors should do to understand and treat the
body or what patients should do to prevent or manage illness. In Mary Put-
nam’s Medical Record letters, the medical argument, rather than the hy-
gienic conclusion, is central; she describes tissue not to tell the story of the
patient but to summarize a medical argument about the “affection” of tuber-
culosis: “Sometimes the centre is already consistent and elastic, and at this
centre the tubercle is gradually formed by exudation, since vascularization
and repletion of tissues by matters destined to be exuded, is common to
inflammation and tubercular formation.” 66 The scientific discourse in which
the story of tuberculosis will be organized is one that entertains multiple
possibilities, that proceeds by constructing evidence that will rule them out
successively, that searches for a unified explanation of the dispersed, contra-
dictory signs and symptoms of illness. For medicine as Putnam Jacobi wrote
it, the body was not a landscape but a scene of instruction (or perhaps a
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Mary Putnam Jacobi
crime scene); the story it told was not of suffering but of detection, of patient
reflection, of postponed certainty and prolonged argument.
Putnam Jacobi’s early medical writing is distinguished by her enthusiastic
use of technical language, her attraction to systematic and deductive expla-
nations, and her construction of arguments by ruling out counterfactuals. In
her letters on Bright’s disease, written at the end of the Medical Record se-
ries, Putnam offers multiple layers of description, from macroscopic discus-
sions of the range of lesions and granulations to microscopic analyses of the
urine taken from various locations in the kidney. These descriptions speak
of the course of the disease counterfactually, by ruling out incompatible the-
ories. Arguments are ramified: Putnam began by opening many possible re-
lations between specific states of tissues and disease processes and then
ruled them out, citing contradictory features of tissue or fluid. As the argu-
ment narrows, possible contradictory explanations are investigated. The story
of tissues and lesions is subordinated to the developing medical argument.
Putnam was also interested in systematic theories that explained many
disparate phenomena—a style of medical research and scholarship that was
deeply at odds with American quietist practice. In her report on Salpêtrière,
the Parisian insane asylum, one of the first hospitals that allowed Mary Put-
nam in its wards, she summarized the theories of the “alienist” Dr. Morel,
who proposed a unified theory of the heredity of nervous disorders includ-
ing “insanity, epilepsy, hysteria, chorea, eccentricities, dypsomania, etc.” 67 As
Putnam’s medical knowledge increased, her sense of what counted as a sys-
tem became more demanding. She moved from the slight, undertheorized,
and facile general theory of mental illness that opened her letters to the
exhaustive system for categorizing skin diseases developed at the Hôpital St.
Louis, a theory that organized organs in pairs via the vascular glands, a sys-
tem for classifying aphasia, and a theory that linked rheumatism and chorea
as “a widely ramifying constitutional disease.” 68
These early texts are also marked by an apprentice’s zeal in the deploy-
ment of technical language, including the feature that M. A. K. Halliday de-
scribes as grammatical metaphor.69 The thin vocabulary so marked in the
theses of mid-nineteenth-century medical students is hypercorrected, as in
this account of a case of rheumatism:
The complete defervescence, the persistence of great pain and swelling after
the redness had disappeared, caused M. Gosselin to fear the formation of a
white swelling (tumeur blanche) although neither the patient’s appearance nor
antecedents indicated scrofula. . . . The inflammation finally subsided about
three weeks later, but the joint was perfectly ankylosed in extension. Examina-
tion then made for the first time discovered a purulent oozing from the urethra,
and the patient acknowledged the previous existence of blennorrhagic accidents.
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Mary Putnam Jacobi
This case is the more interesting because many persons have denied the exis-
tence of blennorrhagic rheumatism in female patients.70
This is the writing of a young woman who was learning a number of new
languages simultaneously. It is also a performance that, unlike any of the
theses, anticipates the lexicon of the mature scientific register. We find
in Mary Putnam’s construction blennorrhagic rheumatism an instance of
M. A. K. Halliday’s grammatical metaphor: the text nominalizes a process or
relation and then uses that nominalization as the basis for further investiga-
tion. Her medical lexicon is also marked by multiple chained nominals; later
in the same letter we read of “an oedmatous phlegmon of the left submaxil-
lary region, whose point of departure existed in the inflammation of a lym-
phatic ganglion at the angle of the jaw,” 71 a compact nesting-box of anatomi-
cal nominals. Together with her focus on the development of the medical
debate rather than on the specificity of the disease process, these features
place Mary Putnam’s medical writing, even at this early and hypercorrect
stage, in the register of mature scientific prose.
Some features of Putnam’s letters can be understood as evidence of her
immersion in the world of French clinical medicine. Following the Parisian
practice of drawing conclusions from systematically collected records of
large numbers of patients, Putnam often analyzed or summarized analyses
of a large number of cases or autopsies to support or refute a proposition.
This figure emerges in Putnam’s account of the International Medical Con-
gress sessions on contagion of cholera and on tuberculosis, in her account of
experiments on the inoculability of tuberculosis, and in her discussion of
Bright’s disease.72
But while Mary Putnam had taught herself to write something like the
modern register of scientific medicine, her letters also included figures of
thought distinctive to nineteenth-century medical writing, including the pe-
rennial desire to view the interior of the living body. Ludmilla Jordanova has
suggested that the desire to unveil the body was congruent with a gendered
unveiling of Nature, seen as a particularly masculine activity.73 In Mary Put-
nam’s fiction, the woman who saw what she should not have seen and the
medical project of seeing the interior of the living body both appear as trans-
gressive, threatening images. In her letters to the Medical Record, these de-
sires became less problematic. Putnam offered an account of the somato-
scope, an apparatus which was essentially a light bulb: a glass tube containing
a platinum coil, connected by copper wires to a battery. The somatoscope
was introduced into the stomach, vagina, or rectum of a cadaver and “en-
abled the observer to see by transparence the walls of the abdomen”;74
Putnam hoped that the device, used on living patients, would be a tool for
163
Mary Putnam Jacobi
diagnosing ovarian tumors and calculi and tumors of the bladder. The soma-
toscope transformed the walls of the body into screens; rather than opening
or severing tissues, it worked through them, so that they were no longer
barriers to sight but fields on which interior organs and structures could be
displayed. The pleasure with which Putnam reported on this apparatus, “too
good, or at least too striking, to be passed over in silence,” would accompany
many of her assisted explorations of the interior of the body in the decades
that were to follow.
MARY PUTNAM AND THE COMMUNE:

TO “GO THE WHOLE HORSE”
On March 11, 1871, Mary Putnam reassured her anxious father that republi-
can excitements had not displaced her medical studies.75 She had passed her
third public examination, and her thesis could be presented whenever the
École de Médecine reopened. Since she had finished her article on the Ger-
man siege, she was now entirely devoted to “natural studies.” Daughterly
reassurances aside, Mary could not help “believing . . . that I am better able
to judge of what goes on in Paris,—than any one can possibly be in New
York.” Her father should trust her intransigence, her willingness to “go the
whole horse,” since that intensity had made her a successful medical student.
On March 18 the Republic became the Commune, the first socialist gov-
ernment in history and perhaps the most interesting. Mary Putnam had al-
ready published an account of the proclamation of the Republic in Putnam’s
Monthly (Sept. 4, 1870). She participated in the political life that led, eventu-
ally, to the Commune, undergoing the privations of the German siege from
September until January and becoming engaged to a French medical stu-
dent who went to the front. After the surrender of the Republican govern-
ment in January and the proclamation of the Commune, Mary Putnam’s old
occupation was gone, since medical lectures were suspended. She was abso-
lutely caught up in life in the Commune:
My interest is immense in the events that are passing, especially since the Re-
public, and as far as I myself am concerned, I feel really quite ready to die in its
defense, especially if in so doing I could help the Réclus. I probably shall not do
so, however, in the first place because I feel that I owe myself as much as pos-
sible to you; in the next, because as yet there is no way clear by which I could
serve the republic, either living or dying.76
She was turned away from the overstaffed ambulance corps, and in mid-
December she had replaced a hospital surgeon who had gone into the army,
but she resigned in January to protest the chief of surgery’s intention to vote
164
Mary Putnam Jacobi
for the monarchists. She was often cold and sometimes hungry but always
had jam, wine, chocolate, and coffee, “and with that one can not be very
miserable.” 77 She moved house to avoid bombardment and slept with some
five hundred of her neighbors.
And her writing speaks coolly and indirectly of this engagement and com-
mitment. Her long article on the siege of Paris, mentioned in her correspon-
dence but not included in her papers, did not see print intact. An unsigned
sketch, “The Clubs of Paris,” was published in Scribner’s Monthly. (The au-
thor is listed as “Mary C. Putnam, M.D.” in the cumulative table of contents
for the bound volume.78 ) Her much longer article, “Some of the French
Leaders: The Provisional Government of the Fourth of September,” also ap-
peared in Scribner’s and was reprinted in Stories and Sketches.79 Signed
“Miss Mary C. Putnam,” it is described as an extract “from a MS. History of
the Siege of Paris, written there before the occupation of the capital by the
Government of Versailles.” 80 The sketch was markedly more sympathetic
than other contemporary American reports, which mourned the absence
of Parisian gaiety during the Commune. Later, Richard Watson Gilder re-
marked in his eulogy for Putnam Jacobi that the article “Some of the French
Leaders” was “one of the ablest ever printed in an American magazine.” This
praise would have soothed young Mary Putnam’s deep annoyance when The
Nation suggested that the article must have been imperfectly translated from
the French, because no native speaker of English would have written so
badly.81
These two articles contain none of the avowals of Mary Putnam’s letters
home. They analyze the collapsing, contradictory positions held by the prom-
inent leaders of the Republic; they report the scenes at workingmen’s clubs
directly but unsparingly. While engaging, they are also adroit and satirical.
“Some of the French Leaders” finds none of the leaders entirely admirable;
the last days of the Republic are presented as a contest among self-
representations. In “The Clubs of Paris,” Putnam’s satire is directed against
the reporters from the Revue des Deux Mondes and the Journal des Débats
who policed the republican working people’s clubs for bad grammar and
dangerous ideas. Mary Putnam herself came to the clubs as “an impartial
bystander”—the position she most enjoyed—and there were times when
she detested both the bourgeois and the “people.” But Mary Putnam was
not actually impartial, only detailed and objective; she saw the talk of the
clubs as developing a new form of life, as manifesting more intelligence than
the government. The scene is drawn:
Everything was strange and grotesque. The room where the meetings were held
was generally small compared with the audience, filled with wooden benches,
and dimly lighted with petroleum lamps. On the benches a motley crowd of
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Mary Putnam Jacobi
men, women, and children,—of which each individual was inflated with the con-
sciousness of his newly recognized dignity as a sovereign people.82
The debates are described rather than summarized; her details of shrill
women and sleepy children, of mixtures of sense and nonsense, transpose
the stylistic conventions of Putnam’s scrupulous, depersonalized medical let-
ters. For her, the scene was impressive:
. . . peculiarly complex . . . strange, pathetic, absurd, foreboding unknown des-

tinies. Such an impression is made by a human foetus scarcely formed,—with
its immense head,—its exaggerated nervous system,—its shapeless, powerless
limbs,—its huge uncouthness,—in which, like pearls hidden in a mantle of
rough skin, lie concealed unlimited possibilities of power, and beauty, and
grace.83
Here, Mary Putnam broke her customary narrative reserve and also con-
nected the political republicanism that animated her earlier stories to the
scientific interest that brought her to medicine. Just as the physician can see
hidden pearls in the uncouth fetus, the republican can see prudent delibera-
tion in the debates of the working people’s clubs; the disciplined eye of the
physician informs the sensibility of the republican. In the Commune, for
the first time, under the pressure of chaotic historical events, the central
intellectual concerns of Mary Putnam’s life came together. It would be the
project of her first decades as a physician to reconstruct that conjuncture.
On May 20, government troops recaptured the city and imposed a bloody
repression. Mary Putnam’s friends the Réclus were jailed; she secured their
release. Alienated and shocked, she stayed in France for a few hectic weeks,
broke her engagement, and passed her final examination. She visited both
Elizabeth Blackwell and Sophie Jex-Blake in England, considered Jex-
Blake’s invitation to teach but decided to accept Elizabeth Blackwell’s long-
standing offer of the chair of materia medica at the Woman’s Medical Col-
lege of the New York Infirmary, and returned to New York in September
1871.84
UNDER HER OWN NAME: MEDICAL WRITING

AND THE PERFORMANCE OF GENDER, 1871–79
Upon her return to New York, Mary Putnam taught materia medica, estab-
lished a private practice, worked in the wards of the New York Infirmary,
and joined the professional organizations that would accept her. Among
them was the New York Pathological Society, where she presented the first
of many specimens in February 1872.85
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Mary Putnam Jacobi
No longer an anonymous apprentice, Mary Putnam experimented with

other styles of gender performance. Sometimes she foregrounded her gen-
der in remarkable ways. For Ann Preston, cross-dressed masculinity was ex-
pressed as medical regularity, but Mary Putnam demonstrated her ability to
go where only male doctors had gone. Putnam’s presentation to the Medical
Library and Journal Association of New York, “Some Details in the Patho-
geny of Pyaemia and Septicaemia,” was quite probably the first paper pre-
sented by a female physician to a mixed medical audience in the United
States. (Sadly enough, the paper is a critique of Lister and Pasteur.) She told
the association that she had become interested in infected wounds during a
“rather prolonged sojourn in the hospitals of a great metropolis.”
I had abundant opportunity for observing this fact [the innocuous effects of gun-
shot wounds of soft tissues], in the case of numerous shell wounds that came
under my observation during the siege of Paris. . . . A curious case of impunity,
even though the bone was involved, was that of another woman who had been
for four years an inmate of the hospital on account of chronic rheumatism in
shoulder, wrist, and knee-joints, all of which were more or less completely anky-
lose. During the bombardment, a shell exploded in the hospital ward, and car-
ried off this patient’s right arm about three inches below the shoulder-joint. It
was a very clean amputation, with very slight haemorrhage; and but little trim-
ming of the wound was needed to make a neat stump, which was speedily cov-
ered by fleshy granulations.86
There is no mention of gender here (except for the unlucky patient’s), but
this is surely a gendered performance. Mary Putnam Jacobi demonstrated
exactly those traits—resolution under fire, surgical sangfroid—which were
held to be impossible for women. She refuted the received opinion that
women physicians could never be surgeons. Quite likely the only veteran of
the siege among the members of the association, she claimed the authority
of that status.
The most significant advance in Mary Putnam’s career, however, was un-
doubtedly her election in November 1871 to the New York County Medical
Society, five months after the admission of Emily Blackwell. Not only did
these women’s admission open to them the professional organizations of the
city; it also laid the basis for women’s admission to the state medical society
and eventually, after many years of struggle, to the American Medical Associ-
ation. The New York society admitted women early; both Philadelphia and
Boston bitterly resisted the admission of women until the 1880s. Putnam’s
name was put in nomination by the president of the society, Abraham Jacobi
(1830–1919), who was to become Mary Putnam’s husband and, for a time,
her collaborator.
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Mary Putnam Jacobi
Abraham Jacobi had come to the United States as a political refugee; he

was among the defendants in the 1852 Cologne Communist trial and had
been imprisoned for two years. Upon his release, he traveled to London,
showed up on Karl Marx’s doorstep, was quickly bundled off to the Engels
household, and decided to immigrate to the United States in 1853 with Eng-
els’s hearty encouragement. Abraham Jacobi’s first home in New York was in
the “lower city,” as Mary Putnam would have called it, or Kleindeutschland,
as it was called by its inhabitants. This neighborhood was organized with the
full array of German voluntary associations; Jacobi was initially supported by
a fund raised by the New York Socialist Gymnastic Association for the Co-
logne defendants. He continued to correspond with Marx, acted as his agent
in the United States, established a busy outdoor practice, wrote, edited, and
investigated the neighborhood’s high mortality rate for the German Society.
For Jacobi, as for other communists of the 1848 movements, scientific dis-
course was a model of utopian public life: only a democratic culture could
organize scientific competition, ensuring that the best work flourished; a sci-
entific culture could support and inform the institutions of democracy, free
from patronage and state control. Having been refused membership in the
established German Medical Society, Abraham Jacobi and other radical phy-
sicians formed a new medical society and established a dispensary in 1856.
The German Dispensary was managed by a collective physician’s association,
with a “self-evolved” organizational form that was never fully fixed. The dis-
pensary was to be a model of scientific, democratic culture, supported by
research; Abraham Jacobi established its Department for Diseases of Chil-
dren, the first systematic pediatric department in the United States.
Abraham Jacobi was also an advocate of German laboratory methods, ad-
vanced in the late 1850s as an alternative to French clinical and statistical
work. His advocacy of these methods allied him with forward-thinking physi-
cians outside the German community; he wrote a bimonthly report on the
European literature for the Medical Journal and was admitted to the New
York Pathological Society. When doctors sympathetic to German medicine
organized the New York Medical College in 1860, Jacobi took the chair in
the Department for Diseases of Children, the first pediatric academic ap-
pointment in the United States. During the Civil War, his integration into
the New York medical community continued; he began to practice at the
Jewish hospital and, while continuing his relation to the Communist Club,
also joined the new Republican Party.87
With his cosmopolitan support for women physicians, his scientific pas-
sion, and his political commitment, Abraham Jacobi was a second chance at
everything that Mary Putnam had left behind, scattered and ruined, in Paris.
For Jacobi, as for Mary Putnam, the connections between medicine and poli-
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Mary Putnam Jacobi
tics were insistent; science was the vehicle for emancipating society from
convention and, eventually, from scarcity and oppression. For both doctors,
the exigencies and competitive passions of the medical societies were the
lifeblood of scientific progress; for both doctors, these exigencies promised
a career open to talents rather than one restricted by gender, religion, or
social class. Ruth Putnam, in her narration of Life and Letters of Mary Put-
nam Jacobi, paints a picture of Jacobi and Putnam walking home from pro-
fessional meetings, absorbed in discussions of pathology; Rhoda Truax por-
trays them as idyllic intellectual partners, like Dashiell Hammett and Lillian
Hellman without the alcohol.88 And who would not be attracted by this pic-
ture of two physicians, both animated by political and social desires, what-
ever the cultural distances between them? Their relationship was always
complex and became more somber with time and mutual loss; much of the
correspondence that could have given us a clearer sense of how they man-
aged their lives is no longer available.89
After Putnam and Jacobi’s engagement in the summer of 1872 and their
marriage (at a secular ceremony in the New York city hall) on July 22, 1873,
Mary Putnam experimented with collaboration as a style of gender perfor-
mance, linking her medical work to her husband’s. Gender performance had
never been routine for Mary Putnam. Her anonymous Medical Record let-
ters had used the reader’s assumption of her masculinity to support a cross-
dressed gender performance distinct from the hygienic regularity estab-
lished by Preston. Her family letters record Mary Putnam’s essays on French
medicine as experiments in costume design; metaphors of dress and clothing
helped her think through the contradictions of being a female physician. She
described her entry into the public space of the École de Medécine: “Day
before yesterday, for the first time since its foundation several centuries ago,
a petticoat might be seen in the August amphitheatre of the École de Méde-
cine. That petticoat enrobed the form of your most obedient servant and
dutiful daughter!” 90 In an apocryphal story, one of the professors of the école
offered to admit her to class only if she would consent to dress as a man; she
encountered him in the courtyard, remarking, “Why, Monsieur, look at my
littleness! Men’s clothes would only exaggerate it; I should never be taken
for a man, and the objection to mixing with the students would be increased
a hundred fold,” convincing the professor to admit her in her own clothing.91
Later, Mary Putnam Jacobi used her signature as a costume. The name
she signed to her publications varied endlessly during her first years in her
profession. Before her marriage, she had signed articles either “Dr. Mary C.
Putnam” or “Mary C. Putnam, M.D.” After her marriage, she experimented
briefly with “M. P. Jacobi, M.D.” and “M. Putnam-Jacobi, M.D.” Eventually,
she settled on “Mary Putnam Jacobi, M.D.” but also used “Mary Putnam-
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Mary Putnam Jacobi
Jacobi, M.D.” 92 All these versions of her name are inflections of the themes
of gender, marriage, and personal agency; the only element that remains
constant in all of them is her professional identification as an M.D.
Soon after her marriage, Mary Putnam Jacobi took on the work of revising
and augmenting Abraham Jacobi’s Infant Diet; this editorial work, like her
translation of Elié Réclus’s essays, was an experiment in coauthorship. The
infant diet book was also an attempt to write for popular audiences.93
The book began as a pamphlet, an extended address by Abraham Jacobi to
the Public Health Association of New York; all the information contained in
his first pamphlet is intact in the augmented, popular edition that Mary Put-
nam Jacobi coauthored. Abraham Jacobi had argued for breast-feeding but
offered suggestions for supplemental feeding when necessary. The pamphlet
included information on how infant saliva affected various formulas, chemi-
cal analyses of cow’s milk, and advice for avoiding the “summer complaint,”
the chronic diarrhea that killed so many nineteenth-century infants. In Mary
Putnam Jacobi’s augmented version, this material is supplemented with dis-
cussions of the physiology of nursing, a comparison between digestion in
infants and in adults, and a defense of small doses of whiskey as a treatment
for the summer complaint. We might expect a popularization to shorten a
professional document, lower the density of its information, and focus on
practical advice; Mary Putnam Jacobi’s popularization doubles the length of
the original text and adds vast tracts of physiology.
Around the kernel of Abraham Jacobi’s observations and chemical analy-
ses, Mary Putnam Jacobi built up layers of information that might have
helped (extremely patient) lay audiences to follow medical arguments as they
had been made in professional contexts. Such education was, she considered,
no less than her duty:
What should be the nature of a popular essay? To judge by the multitude of
little books that are lavished upon young mothers to help them in the care of
their children, one thing is supposed to be fundamental—theory, or an explana-
tion of scientific basis for the precepts laid down, must be rigidly avoided. . . .
Now we assume, contrary to this dictum, that the theory of a fact does concern
every intelligent person who is interested in its application.94
Mary Putnam Jacobi saw her coauthored book with Abraham Jacobi as a
translation; scientific information was to be mediated and explained so that
it could be absorbed by a new audience. Translation would ensure the more
ready acceptance of medical advice; the mother would become
the intelligent passenger on a vessel, who learns how to read the chart and to
foresee the directions and incidents of the voyage, even while submitting to the
control of the captain, so the mother may learn the general plan of her child’s
life, its future course, and the accidents that beset it, and, in regard to the details
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Mary Putnam Jacobi
to which her attention is called, learn much, if not all, of their scientific
relations.” 95
Like Abraham Jacobi, Mary Putnam Jacobi saw scientific democracy as a

matter of disseminating knowledge while preserving professional authority.
The mother who read Infant Diet was no more to be entrusted with directing
the medical care of her child than an educated passenger would have been
given the wheel of a ship. Husband and wife, both physicians, addressed
together the uneducated female reader; the medical wife fashioned a medi-
ating language that stabilized the reader as the receiver of advice. The au-
thority of the profession was established all the more securely, and the fe-
male care-giver rendered all the more compliant.
Mary Putnam Jacobi’s concessions to her audience in Infant Diet were
focused and deliberate. She used relatively nontechnical language, scaling
down the lexical armamentarium she had developed in Paris. She offered
background, and she restricted the text’s information to “what is already posi-
tively assured to science” rather than including the “new researches or the
original criticism which alone constitute the raison d’être of a book pro-
fessing to be scientific.” 96 But within these boundaries, Putnam Jacobi con-
nected the popular essays to those directed toward physicians: “What is told
should be the same in kind as what is told to the scholar. Few women seem
to be aware of the insult implied in the assertion ‘that the theory is of no
importance to them.’ Of whomsoever this assertion may be truthfully made,
it must be said that he is destitute of the highest characteristic of an intelli-
gent being—the desire, namely, ‘to understand himself and the things
around him.’” 97 That was an insult Mary Putnam Jacobi never gave to any
of her audiences, happily as they might have tolerated it.
While Mary Putnam Jacobi’s collaborative popularization was a complex
gender performance, so were her more properly professional publications.
In them, she offered a compliance with norms of professional discourse that
is dazzling in its rigor. If her popular writing was not technical but discursive,
her scientific writing was ruthlessly compressed; if her popular writing of-
fered explanation, her scientific writing refused to provide context for the
reader; if her popular writing concerned what was generally accepted, her
scientific writing continually pushed the parameters of science. None of the
thirty-six scientific articles that Mary Putnam Jacobi wrote during the 1870s
refers to her own gender, but she did write an unpublished essay in 1873
on the topic of gender. Her “Reply to Prof. Munsterberg” responded to his
argument against the higher education of women, an argument cast in Hege-
lian terms: Munsterberg had argued that a woman must “be taught to con-
sider as the really best for her, what is in the highest interests of the whole
of society, even if be second best for the individual.” 98 Mary Putnam Jacobi
171
Mary Putnam Jacobi
objected, “Who is to decide?” and then, fresh from the influence of the Ré-
clus family, she referred to Fourier:
Fourier, in many respects the most sagacious of modern Socialists—is almost
alone in perceiving that Nature really varies from the start. That about a third
of all boys possess the tastes and capacities of girls, and, if left to themselves
would follow their quiet and sedentary occupations. And correlatively about a
third of the total number of girls thoroughly hate the restrictions and limitations
imposed upon their own sex—and crave the energetic turbulence of boys. Fou-
rier’s scheme of society, provides for a minority representation in each case: his
Little Clans consist of one third of boys, and two thirds of girls: his Little Hordes,
one third of girls, and two thirds of boys.99
If such a plan were followed, Putnam Jacobi claimed, nature would be ex-
panded, capacities encouraged, and individuals made happy. Similarly, in her
early medical writings, it is as if Mary Putnam Jacobi declared: “I, the writer,
am a woman, as you can see (usually) by my name. However, I write medi-
cine like a man; in fact, the form of medicine I am writing, bristling with
laboratory results and stories of combat, is especially masculine.” Such a per-
formance differed from Preston’s cross-dressing, which proclaimed its mas-
culine regularity but inflected its medical register as feminine by focusing
on prevention and hygiene. Mary Putnam Jacobi insisted on herself as the
female writer of insistently masculine medicine, the girl in the horde,
thereby denaturalizing the conjunction between knowledge and gender. Or,
as she would have put it, encouraging “various social combinations . . . [and]
opportunities for interchange of function between the sexes.” 100
THE ANONYMOUS SUBLIME: THE QUESTION

OF REST FOR WOMEN DURING MENSTRUATION
Yet another, still more complex, style of gender performance is demonstrated

in Mary Putnam Jacobi’s entry in the competition for the 1876 Boylston
Prize, The Question of Rest for Women during Menstruation. The general
background to this publication is well-known: Harvard professor of materia
medica Edward H. Clarke had argued in Sex in Education: Or, A Fair
Chance for Girls that the establishment of puberty and the demands of the
monthly cycle made higher education dangerous for young women and
girls.101 Although his theory was widely accepted, many physicians were dis-
satisfied with the extremely impressionistic cases offered in the book and
with its lack of sustained physiological argument.102 The Harvard medical
faculty, therefore, included among the topics set in 1874 for the Boylston
Prize essay, “Do women require bodily and mental rest during Menstruation,
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Mary Putnam Jacobi
and to what extent?” 103 Cambridge feminists, led by C. Alice Baker, met with
members of the medical school faculty and asked if an essay by a woman
physician on that topic would be eligible.104 (Feminists did not take the suc-
cess of women physicians lightly, and Boston feminists in particular, since
the days of Harriot Hunt, had used all the means at their disposal to influ-
ence the intransigent Harvard Medical School.) Dr. Morrill Hyman assured
Baker that such an essay would be welcome; although he was no supporter
of women’s education, he had been impressed with Mary Putnam Jacobi’s
previous work. Baker urged Mary Putnam Jacobi to enter the competition;
her spadework allowed Putnam Jacobi to write with confidence, assured that
she would not simply be ruled ineligible.105
The spectacle of open, anonymous competition was integral to nineteenth-
century American medical publication. It was quite usual for medical jour-
nals, bulletins, and schools to offer prizes, both in general categories, such
as therapeutics, and for the solution of pressing problems, such as a cure for
cholera. Anonymous prize competition offered women physicians the possi-
bility of eliding their gender, fulfilling Marie Zakrzewska’s program for a “sci-
ence which has no sex.” 106 In Philadelphia, for example, Melissa Webster, an
1870 Woman’s Medical College of Pennsylvania graduate, had been awarded
a prize for an essay in clinical practice; her victory was the sweeter because
the journal that sponsored the competition had opposed the education of
women physicians. The editor was forced to recognize at least the possibility
of exceptions.107
The dynamic of the anonymous competition was double-edged: It offered
to graduates of the women’s medical colleges the possibility, perhaps their
only possibility, of being judged on the basis of their medical knowledge
without being marginalized. But, since the winner of a competition was by
definition exceptional, a woman who triumphed in this setting would never
be taken as representative. Many women physicians, however, accepted their
status as exceptions; both Preston and Putnam Jacobi expected women to
remain a minority in the medical profession. With all its complex inflections
of eccentricity and individual destiny, the status of exception, of the girl in
the horde, was one that Mary Putnam Jacobi accepted and even sought.
The issues of Clarke’s book—menstruation, energy, and intellectual
work—were central to Mary Putnam Jacobi’s political consciousness and
medical research. She took the competition as an opportunity to broaden,
perhaps to subvert, the constraints of normal scientific writing and to open
the discourse of medicine to women’s voices, even though in other texts Put-
nam Jacobi discounted the significance of lay persons’ accounts of sickness
and health. The Question of Rest for Women during Menstruation is a text
which is beside itself in a number of ways: the author is not who [he] seems;
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Mary Putnam Jacobi
[she] is not writing, entirely, for the reasons that led to her having been solic-
ited; she does not believe, in some important senses, the authorities she will
introduce into the text.
The medical issues raised by The Question of Rest for Women during Men-
struation include the perennial questions of ovulation, the nature of the
menstrual fluid, the relation of menstruation to fertility, and the relative im-
portance of the ovaries and the uterus in regulating menstruation. These
issues were not at all settled during the 1870s, and Putnam Jacobi had some-
thing to say about all of them. She argued, for example, the singular position
that it is possible to conceive fourteen days after the start of a menstrual
period, the time physicians usually recommended to women as “safe.” 108 Put-
nam Jacobi saw all these questions as related to cellular nutrition, a process
which she later defined as central to the understanding of hysteria. Nutrition,
for Putnam Jacobi, was no mute assimilative function; it was enmeshed with
sexuality, reproduction, sensation, and consciousness. While Thomas La-
queur characterizes Putnam Jacobi’s essay as presenting a desexualized un-
derstanding of women’s physiology,109 within the context of nineteenth-
century gynecology Putnam Jacobi was actually connecting the reproductive
crises of women’s lives to processes of nutrition that biochemistry was be-
ginning to study. Her analysis deemphasized sexual difference, but it fore-
grounded a sense of women’s agency and consciousness. In the framework
of cell nutrition, the menstruating woman was undergoing not a crisis of
sexual stimulation or receptivity but a normal event in the growth and death
of tissues. Menstruation was not a congestion of the uterus, not an erection
of the female organs, and certainly not a hemorrhage; it was not analogous
to the mammalian rut. Rather, it was part of the process of forming reserves,
a process that Putnam Jacobi was later to connect to the possibility of agency,
the ability to organize sensation. Far from constructing a feminine mind
“presiding over a passive, nutritive body,” 110 Putnam Jacobi framed women’s
reproductive cycles within the context of their overall strength and mental
energy, or what she called force.
Mary Putnam Jacobi considered herself a positivist, a self-description as
common among late nineteenth-century progressives as the belief in the in-
heritance of acquired characteristics had been in the middle of the century.
And one phase of her argument in The Question of Rest for Women antici-
pates the programme of positivist social scientific research. She investigated
whether women did in fact feel themselves to be in need of rest during
monthly periods and whether menstrual pain and fatigue were more com-
mon among educated women than among uneducated. What makes Putnam
Jacobi’s positivism interesting is the source of her evidence; for Putnam Ja-
cobi, in this text, self-report is a perfectly reliable source of information
about women’s physiology. To collect information about rest during menstru-
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Mary Putnam Jacobi
ation, Putnam Jacobi simply circulated a thousand questionnaires and col-

lated the results of the 268 that were returned. The questionnaire was
straightforward:
The undersigned, desirous of collecting reliable statistics in regard to the

menstruation of women in America, would feel indebted to all who would an-
swer accurately, the following questions.
No signature is necessary.111
The questions that follow concern the respondent’s education and occupa-
tion, habits of exercise, health history, and menstrual history. They ask baldly:
“Has it been necessary to rest during period? Strength, as measured by ca-
pacity for exercise. How far can you walk? Have you ever been treated for
uterine disease? Are you thin or stout, rosy or pale, tall or short? Has any
change taken place since twenty in color, flesh, or strength?” 112 It is common-
place in Foucauldian studies of medical practice to see such surveys as a
means of policing docile populations; one researcher writes that the mass
medical survey is “an instrument of order and control, a technique for man-
aging the distribution of bodies and preventing their potentially dangerous
mixings.” 113 Certainly surveys can be used in that way; certainly they have
been used in that way.
However, Putnam Jacobi’s survey is not an allegory of control but a perfor-
mance that inscribes the relentlessly lay voices of women within the dis-
courses of medicine. The survey was a tactic for reclaiming from medical
surveillance the experience of the monthly period, an event which could de-
fine a nineteenth-century woman as a perpetual patient. Using mathematical
techniques no more sophisticated than taking simple averages, Putnam Ja-
cobi combed through the relations among her questions, established classes
of respondents, and determined that pain during menstruation was related
neither to educational level nor the habit of taking rest but rather to the
respondent’s general vigor, habits of exercise, and “steadiness of occupa-
tion.” 114 Putnam Jacobi’s correlations, however, are less compelling than the
short quotations from the surveys that are included in her tables. Women’s
words, rather than the numbers that summarize them, constitute the evi-
dence for Putnam Jacobi’s argument. In the table that correlates the respon-
dents’ general health with the number of miles that they walked daily, we
read in the “General Health” column such remarks as “Very fine,” “Good.
Sick headache,” “Strong in America,” “Delicate,” “Invalid from 17 to 25, now
stronger,” and “Robust, not accustomed to walk.” Respondents report that
they can walk daily “Four miles till after 2nd child,” or “All day,” or “Not
much,” or “Long distance.” 115 No contemporary survey taker would allow
respondents to answer a question about “how much” in time or distance,
depending on their preference. But in Putnam Jacobi’s essay, these variations
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Mary Putnam Jacobi
record how patients themselves described their own health. The survey is
not simply as authoritative as Clarke’s observations; within the positivist
framework assumed in this text, the information gathered from many women
becomes more authoritative than Clarke’s observations could ever be.
Within the history of feminist discussions of women’s health, Putnam Ja-
cobi’s argument resonates with another survey done twenty years earlier by
Catherine Beecher.116 Beecher demonstrated the general poor health of
women in the United States; the hundreds of middle-class women who re-
sponded to her survey, listing the health of the ten women they knew best,
wrote litanies of disorder: “Milwaukee, Wisc. Mrs. A. frequent sick head-
aches. Mrs. B. very feeble. Mrs. S. well, except chills. Mrs. L. poor health
constantly. Mrs. D. subject to frequent headaches. Mrs. B. very poor health.
Mrs. C. consumption. Mrs. A. pelvic displacements and weakness. . . . Do
not know one healthy woman in the place.” 117 Supporters of the medical
education of women had used Beecher’s survey to argue the urgent need for
improving women’s access to health care. But, of course, that argument also
rationalized women’s status as patients, the restriction of their activities, and
their exclusion (for their own good) from demanding professions. Putnam
Jacobi’s survey portrayed American women as generally vigorous, physiologi-
cally uncomplicated, and potentially ready for anything; these ladies with
“excellent” health who walked “5–10–20 miles” a day were not likely to be
laid low by menstruation.
The Question of Rest during Menstruation used the evidence of women’s
experience to contradict a (male) physician’s prolonged clinical observation.
By “working up” that experience in the survey, Putnam Jacobi not only de-
vised a new form of medical research, extending the clinical statistics drawn
from Parisian hospitals to new populations, but also smuggled women’s
voices into the emerging scientific discourse of medicine. The Question of
Rest destabilized medicine’s understanding of the male body as normal and
the female body as fragile. The women in Putnam Jacobi’s text are not in
need of special treatment by women physicians because they are not in need
of special treatment at all: neither puberty nor reproduction is a crisis for
them; both are normal physiological processes. The Question of Rest can be
seen, within this context, as an episode in Putnam Jacobi’s consistent refusal
to join many nineteenth-century feminists in accepting a separate sphere for
women, however expanded or redefined.
Putnam Jacobi’s argument from her survey information simplified the
ramified tree structure that she had developed in her letters to the Medical
Record. The survey allowed her to construct a body of cases that corres-
ponded to the question set by the Boylston Prize Committee. She advanced
enthymematically the proposition that if women require rest during men-
struation, then many women will either take such rest or suffer ill effects
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Mary Putnam Jacobi
from neglecting it; the survey collected and collated data disproving the
proposition. The basic structure of argument through negation remains, sup-
ported by data composed collaboratively by the writer and her respondents.
Paradoxically, Putnam Jacobi rejected the idea that women enjoyed spe-
cial insight into female physiology. She would have been shocked by Eliza-
beth Blackwell’s advice that women medical students should cultivate skepti-
cism toward their male professors or by her assertion of the “positive fact”
that “methods and conclusion formed by one-half of the race only, must nec-
essarily require revision as the other half of humanity rises into conscious
responsibility.” 118 Instead, Putnam Jacobi urged her students to resist taking
any special role as women physicians, to demand access to the whole of clini-
cal medicine, including surgery.119 In her 1880 inaugural address at the open-
ing of the Woman’s Medical College of the New York Infirmary, she sternly
warned the apprentice physicians, “What the patient has to tell you consti-
tutes precisely the least important part of what you must learn about him in
order to be able to understand his case, and to do him any good.” 120 The
truly scientific, and therefore truly benevolent, physician saw the patient not
as a source of information but as the location of disease that required treat-
ment. While Putnam Jacobi offered women’s self-reports as reliable informa-
tion in the Boylston Prize essay, in other contexts she dismissed them as
information that the physician would do well to forget.
The Question of Rest during Menstruation subverts the ideological associ-
ation between femininity and fragility; it offers distinctly feminine voices a
place of authority within the register of scientific medicine. Putnam Jacobi
also refused both the benefits and the limits of a separate sphere for women,
defining their gender-specific physiology as an extension of general physio-
logical processes and assimilating their life histories to a narrative of matura-
tion, education, and maturity that is not dimorphic. Putnam Jacobi’s essay is
perhaps a unique instance of standpoint theory used to support a critique of
gender differentiation. Given the intricate dialectics of the separate sphere,
a physiology that deemphasized the specificity of women’s sexual and repro-
ductive experience also offered the possibility of depathologizing feminine
physiology.
The Question of Rest, in its initial anonymous presentation, would have
been read as the writing of a male physician; in its eventual signed publica-
tion, it presents the writer, tacitly but powerfully, as female. The writer’s
discourse, further, encloses and contains the many female voices of the sur-
vey, voices which the writer has herself constructed by excerpting and ar-
ranging them. Finally, the force of the text is to assimilate women, as objects
and agents of medical care, to the norms of science. The speech act effected
by Putnam Jacobi’s anonymous entry into the Boylston Prize competition—
the demonstration that a woman is just like a man—is repeated in the argu-
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Mary Putnam Jacobi
ment of the essay. But since it was the gender of the writer that rendered
this Boylston Prize essay, alone among the many written in the nineteenth
century, remarkable to a general audience, the essay undoes its own elision
of gender. We read The Question of Rest because it was written by a wo-
man; what we read in The Question of Rest is a denial of the significance of
gender. The text as performance contradicts the text as argument. However
much Putnam Jacobi wrote a medicine identical to that written by male phy-
sicians, it was not the same for her to be a doctor as it was for a man; her
writing was necessarily a performance of the gender that she had worked
to elide.
Although The Question of Rest during Menstruation was Mary Putnam
Jacobi’s most visible medical publication during the 1870s, it was by no
means her only major work during that decade. Her “Pathogeny of Infantile
Paralysis” was the first systematic discussion of that disease. Putnam Jacobi
also continued to write essays on pathology, fetal development, children’s
diseases, and particular drugs.121 None of these were journey-pieces, al-
though by her tenth presentation to the New York Pathological Society, Mary
Putnam Jacobi knew the drill. Her interest in technologies of visualization
continued. She wrote two essays on experiments with the sphygmograph, a
device which recorded pulsations, usually from the heartbeat, on a rotating
cylinder. More dramatically than the somatoscope, the sphygmograph per-
mitted a visualization of the interior of the body without any intrusive open-
ing of its surfaces.122 The sphygmograph mediated the interior of the body
and offered a representation of its actions that was as abstracted and defami-
liarized as Mary Putnam’s anatomical descriptions were hallucinatorily pre-
cise. The apparatus came between the transgressive medical eye or hand
and the hidden spaces of the body; instead of producing something that
looked like an organ or a tissue, it offered an abstract tracing that required
interpretation.
We might define the medical aesthetic of Putnam Jacobi’s mature writing,
as demonstrated in these essays, as one which valued what is made visible,
through detailed explanation, technique, or manipulation, rather than what
is apparent. Putnam Jacobi offered proof through negation rather than posi-
tive connection; she was much more likely to systematically disprove a series
of alternate hypotheses than to directly support one of them. As in the very
early Medical Record letters, arguments proceed through ramified decision
trees, although Putnam Jacobi had become much more flexible in her con-
struction of these arguments. In this mature writing, Putnam Jacobi has vir-
tually abandoned the systematic theorizing that attracted her as an anony-
mous student, but she continued to locate her arguments in ongoing debates
about medical questions, to compose them as intertextual rejoinders to
other physicians.
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Mary Putnam Jacobi
WRITING THE LARGER LIBERTY: MARY PUTNAM JACOBI

AS ESTABLISHED MEDICAL WRITER
In the 1880s and 1890s Mary Putnam Jacobi was recognized as a major figure
in several fields of medicine; her work with hysteria, anemia, diseases of the
uterus, and nervous diseases, including tumors, paralyses, and meningitis,
was solicited by professional societies and published in major journals. These
topics are at the contested crossroads of nineteenth-century disputes about
gender, constitutional strength, mental ability, and social role. Putnam Ja-
cobi’s Essays on Hysteria intervened in these disputes; elsewhere, as in her
magisterial (and massive) “Studies in Endometritis,” she addressed them
by implication.123
In her books on hysteria and anemia and in several of her gynecological
works, Mary Putnam Jacobi also took on Silas Weir Mitchell, one of the cen-
tral figures of late nineteenth-century medicine. Mitchell, the virtual dean of
Philadelphia medicine, a novelist, and a translator, was one of those “literary
physicians” that the young Mary Putnam dreaded becoming; he wrote a
brace of historical novels and novels of manners. He was best known in the
nineteenth century for Fat and Blood: And How to Make Them, his enor-
mously successful book on the rest cure for nervous diseases; for contempo-
rary readers, he is the prototype of the evil physician in Charlotte Perkins
Gilman’s “The Yellow Wall-Paper.” 124 If Mary Putnam Jacobi entered medi-
cal life in the 1870s by experimenting with collaboration, she spent the 1880s
in agonistic conflict.
In 1880, three years after the first edition of Fat and Blood, Putnam Jacobi
copublished On the Use of the Cold Pack Followed by Massage in the Treat-
ment of Anaemia, written with Victoria A. White, her associate at the New
York Infirmary for Women and Children. Unlike Mitchell’s congeries of ane-
mic, hysteric, and generally nervous patients, this modest, clinical book is
focused on the treatment of a single disease, anemia, for which Putnam Ja-
cobi devised relatively precise diagnostic tools. The book follows eight cases
very closely, tracing the composition of the patients’ urine during and after
each was wrapped in the wet sheets of the “cold pack.” Their heartbeats
were traced with the sphygmograph; their temperatures were recorded.
From these measurements, Putnam Jacobi concluded that the cold pack had
improved excretion and nutrition, so that an improved blood supply cor-
rected the patients’ anemia. Weir Mitchell’s well-known account of the rest
cure as an experience of female submission to an omnipotent physician had
offered no systematic discussion of why the cure might work. But Putnam
Jacobi specified a working hypothesis, modified during the course of the
study, and pointedly began her case histories with a patient for whom the
rest cure had failed:
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Mary Putnam Jacobi
The prolonged rest in bed might by some persons be credited with the largest
share in the recovery, since the essay of Weir Mitchell has so widely popularized
the idea of rest in the treatment of anaemia. I think myself, however, that this
rest was of the least consequence in the case. The girl had never been over-
worked in any way, hence the etiology of her anaemia was entirely different from
those in which rest is so beneficial; moreover, owing to her great debility, this
patient had been in a state of nearly complete repose for two or three months
before I saw her, from incapacity to do otherwise. Yet her condition steadily
deteriorated; she was wasting away from slow starvation.125
On the Use of the Cold Pack Followed by Massage in the Treatment of Anae-
mia is a systematic argument against “Weir Mitchell’s popular little essay,” as
Putnam Jacobi contemptuously called it.126 But of course, Weir Mitchell’s
book was read everywhere and saw at least seven editions, while On the Use
of the Cold Pack was unread in the developing field of gynecology and en-
tirely neglected in the literature on nervous disorders. The very precision
with which she set up her clinical trial narrowed her influence; anemia was
a topic of limited range and salience. Putnam Jacobi’s very compliance with
the constraints of mature scientific writing had marginalized her work.
In her Essays on Hysteria, Putnam Jacobi relocated her investigations into
the main territory of the debate. She confronted a paradox: Hysteria was
understood as a nervous disorder and therefore as an expression of tempera-
ment or constitutional predisposition. But the symptoms of hysteria, includ-
ing vasomotor spasms, and “the special, mental, motor, and sensory phenom-
ena of hysteria” often involved the reproductive organs. And hysteria was
also implicated with “moral and social conditions.” 127 These are exactly the
issues which Weir Mitchell’s rest cure confounded; for him, nervous disease
was a moral failing, and stimulation with electrical current could correct anx-
iety.128 This confusion, Mary Putnam Jacobi undertook to resolve; she would
discuss both moral and social issues and properly physiological questions,
but each in its own terms.
For Putnam Jacobi, moral issues and physiological questions were medi-
ated by “force” as it was stored in the brain; differences in the ability of
individuals to store such force determine, through the nutrition of their
nerve tissue, how they are affected by sensation. Putnam Jacobi suggested
that weakened nerve tissue (whether debilitated by constitutional weakness,
illness, or overwork) might be overtaxed by relatively ordinary sensations,
failing to store force or to take in nourishment. She therefore sketched out
a narrative of the onset of hysteria, a narrative located in the “cortex of the
hysterical brain”: storage power becomes deficient; centripetal (sensory) im-
pressions are stored in sensory centers rather than the cortex; centrifugal
activities (voluntary acts) decline; sensory centers fail to discharge stored ma-
terials and become hyperexcitable; sensory centers inhibit brain activity.129
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Mary Putnam Jacobi
Or, as a later physician would put it, hysterics suffer from reminiscences.
Putnam Jacobi, as a positivist, assumed that consciousness was the accumula-
tion of memory traces; she also assumed a psychic economy in which expen-
ditures must be balanced against stored energetic capital. But Putnam Ja-
cobi’s hysteric was not transfixed on her own sensations; hysteria was not
self-absorption but the inability to absorb sensations or to forget them once
they had been stored. The hysteric was not too selfish but too sensitive,
unable to impose her conscious direction on the overwhelming flow of
sensations.
Putnam Jacobi, like most nineteenth-century physicians, often connected
hysteria with the uterus. But she saw its fundamental origin as nervous and
understood hysteria as a kind of mourning, as if the brain withdrew in dismay
from its own impaired function. Affections of the reproductive organs could
cause this failure of function; the first case history in Essays on Hysteria
concerns a patient whose “profound consciousness of distress” was traced to
a prolapsed uterus, and cured by the cup-pessary.130 Uterine affections could
restrict the flow of blood to the brain, and “the arrest of cerebral activities
suggests as irresistibly oppression, defeat, humiliation, disaster in external
events; imposes subjectively the depressing emotions of mortification, dis-
trust, and apprehension—the depression of spirits which is unconquerable,
even when the patients themselves recognize its objective groundlessness.” 131
“Some Considerations on Hysteria” investigated, in medical terms, the di-
chotomy that had informed Putnam Jacobi’s early novella, Concerning Char-
lotte—the relation between feminine passivity and activity. But while it was
the sadistic and active Charlotte who posed a danger to herself, her beloved,
and the innocently passive Margaret, here the passive faculties of sensation
(Putnam Jacobi’s “centrifugal” activities) are dangerous impediments to the
active faculties of movement, thought, and action (Putnam Jacobi’s “centrip-
etal” activities). Putnam Jacobi saw these faculties traversing the nerves like
waves; incoming waves of sensation could break up and disorganize outgoing
waves of action. No one would want to argue for such an understanding of
sensation and action today, just as no one would argue for Freud’s hydraulics
of consciousness, but Putnam Jacobi’s understanding of hysteria placed the
disease in the nervous system and the brain. This theory of hysteria sug-
gested a therapy that was both physical and mental, that respected the hys-
teric’s consciousness and potential strength. The rest cure sought to relax
the will of the patient, subjecting her to days of bed rest, tiny feedings of
milk, massage, electrical stimulation, daily paternal visits from the doctor
and weekly letters from her spouse, but Putnam Jacobi saw the patient’s con-
sciousness, beleaguered by a surplus of sensation, suffering from the sup-
pression of its own ideals, as the agent of cure. More broadly, the essays
on hysteria represent Putnam Jacobi’s most sustained attempt to refunction
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Mary Putnam Jacobi
passive sensation and active thought as complementary processes; the action

of the physician, not surprisingly, is to balance or, in Putnam Jacobi’s word,
“harmonize” the relation between these two poles rather than to suppress
one or the other. The hysteria essays suggest an understanding of women’s
agency, including the agency of the woman physician, which is risky but not
dangerous, which seeks a change in the state of the object but is not sadistic,
which regulates and “harmonizes” sensation but does not preclude passivity.
This understanding led Putnam Jacobi back to the “moral and social” ques-
tions that she had avoided for a full decade in her medical writing. In dis-
cussing the treatment and prophylaxis of hysteria, she focused on the emo-
tional and mental life of the patient in relation to the physiology of the
disease:
The inference has too often been drawn [from changes in the condition of the
hysteric prompted by mental events] that the symptoms were “imaginary” and
within the control of the patient, while the fact that the imagination, the con-
sciousness, the very citadel of personal existence, has been invaded by a morbid
process, cannot fail to threaten paralysis of volition and self-control.132
Putnam Jacobi’s clinical practice employed the widest possible range of

devices to treat hysteria. We have Charlotte Perkins Gilman’s account of
what it was like to be treated by Mary Putnam Jacobi for a nervous disorder,
an inconclusive series of fragments that contrasts with the passionate aria of
“The Yellow Wall-Paper.” In her address at the unveiling of the Philadelphia
memorial tablet for Mary Putnam Jacobi, Gilman spoke of having met her
in New York, of their discovering common interests, and of Putnam Jacobi
making Gilman an offer: “She had originated a system of treatment which
she desired to try for that ailment [neurasthenia], and nobody would allow
her to do so. I said I was perfectly willing to let her try it on me, and we
formed a compact.” Gilman went on to speak, with maddening vagueness,
of Putnam Jacobi putting her “through a course of most remarkable perfor-
mances” during her daily office visits.133 Luckily, Gilman’s recently published
diaries are somewhat more forthcoming: in her entries for 1901, she wrote of
being treated with an “electric plat” to the solar plexus; of taking “phospho-
glycerates in wine,” which she enjoyed; of Putnam Jacobi reading her manu-
script and then setting her to work writing in the doctor’s office; of reading
a book, The Cell; and of building kindergarten blocks, all the while playing
on a women’s basketball team.134 Putnam Jacobi’s scandalous regimen, then,
included electrical stimulation (one of her continuing interests and also a
part of Weir Mitchell’s rest cure), drugs, and a regimen of “moral” interven-
tions that directed the patient toward the external world and activity within it.
Because Putnam Jacobi understood hysteria as a nervous disease, she ad-
vocated changes in social conditions as a means of prevention; her emphasis
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Mary Putnam Jacobi
on the nervous, rather than a uterine, origin for the disease allowed her to
account for women’s susceptibility to hysteria without allegorizing it as
intrinsically feminine. The characteristic moral traits of the hysteric, she
claimed, were—when they appeared at all—results rather than causes of
illness: “The most amiable, unselfish, and affectionate character [can] be not
infrequently found among [hysterics].” 135 Putnam Jacobi recognized that the
diagnosis of hysteria was applied selectively and judgmentally: “A distinction
is often made, based upon the sex and temper for the patient. If this be a
female, and notably selfish, the case is pronounced hysteria. If a man, or
though a woman, amiable and unselfish, the case is called neurasthenia.” 136
If hysteria was caused by a decreased storage capacity, an inability to
screen out or forget sensations, then the moral impressions most useful in
preventing hysteria would be those effected by the patient’s own activity.
Putnam Jacobi quoted approvingly the neurologist Eulenberg, who held that
it was social conditions rather than uterine “catarrhs and erosions” that ren-
dered women susceptible to hysteria: arrest of will and independent thought;
suppression of the ability to test individual subjectivity against external ob-
jects; restraint or supervision of all impulses; and especially opposition to
“any attempt at emancipation from the limits of a narrow and trivial exis-
tence.” 137 As a physician, Jacobi recommended change of scene, change of
occupation, and exercise on horseback, rowboat, or the Butler Health-Lift.
As a citizen, Putnam Jacobi was active in various attempts at emancipation,
including the League for Political Education and the Consumer’s League;
she met with young working women under the auspices of the Knights of
Labor and encouraged unionization.138
Throughout the 1880s and 1890s, Putnam Jacobi continued to publish on
more conventionally physiological topics. One strand of her work dealt with
uterine disorders; among these publications, we can count not only her ex-
tensive “Studies in Endometritis,” published through the 1885–86 issues of
the American Journal of Obstetrics and totaling some eighty pages of text,
but also her articles on intrauterine medication for the Medical Record and
the American Journal of Obstetrics and a short essay on gynecological uses
of electricity in the proceedings of the alumnae association of the Woman’s
Medical College.139 Putnam Jacobi wrote up surgeries, especially heroic sur-
geries of the abdominal cavity, including two articles on “Battey’s operation,”
the removal of ovaries and connected tissue, and an account of trephining
the sternum.140 More and more, Putnam Jacobi was called upon to write on
medical politics, especially the medical education of women. Although her
bibliography lists only one such publication for the 1870s, there were seven
in the 1880s and six in the 1890s. Putnam Jacobi’s performance of these
registers demonstrates her self-conscious adaptation to professional and lay
audiences.
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Mary Putnam Jacobi
In Putnam Jacobi’s writing to physicians, we can trace many of the ele-

ments that, according to Halliday, distinguish a mature scientific style. As
early as the Medical Record letters, Putnam Jacobi’s medical writing was
marked by the use of grammatical metaphor, heavy chaining of nominals,
the elision of personal forms, the use of a technical rather than a colloquial
vocabulary, and the organization of the text as a disciplinary argument rather
than a story about nature. Putnam Jacobi’s prose was from the beginning
extremely dynamic—it varied in different contexts. Even when her early
writing deployed a specialized vocabulary, it was seldom syntactically simple.
The Medical Record correspondence, to appropriate Mary Putnam’s meta-
phor for the communard clubs, is like a promising fetus: a median form re-
calling the undifferentiated medical writing of the mid-nineteenth century,
drawing on the conventions of the familiar essay. But turn-of-the-century
texts, published in specialist medical journals, were addressed entirely to a
medical audience.
By the 1880s and 1890s, the stylistic sampler arrayed in the Medical Rec-
ord correspondence was reorganized into a number of distinct discourses
addressed to particular audiences. Putnam Jacobi produced a variety of med-
ical styles at distinct levels of discourse and also found ways to present the
dreaded “theory” in writing addressed to lay audiences, to offer a distinct
authorial voice in professional texts, and to perform gender in interesting
and inventive ways. Putnam Jacobi’s essay “The Prophylaxis of Insanity,” col-
lected in Essays on Hysteria, was originally addressed to sociologists. Put-
nam Jacobi discussed insanity as a hereditary disease:
There are as many degrees in the soundness of men’s minds as in the soundness
of their digestions. Study of the organism of the family, sometimes in several
generations, often serves to detect flaws in the individual organization too mi-
nute for notice. It is to the family organism that especially applies the doctrine of
the blending of apparently opposite elements,—as genius and insanity,—both
springing from an unstable equilibrium of the nervous system. These elements
sometimes, though rarely, blend in the same person. But far more frequently it
is inheritance from the undeveloped side of an organization of genius which
results in an organization of imbecility.141
This passage is marked by modest use of chained nominals; we read of the

organism of the family and then of the family organism, which functions as
a grammatical metaphor. The unstable, undeveloped, and flawed elements
of the organism are manifested in successive generations; from this compari-
son, Putnam Jacobi extrapolates an inheritance that determines, in part, the
disposition of individuals. The comparison becomes an explanatory frame-
work, a way of associating propositions elliptically rather than explicitly nam-
ing their logical relations. Like the Medical Record letters, this paragraph is
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Mary Putnam Jacobi
extremely complex syntactically: modification is heavy and densely layered.

But although Putnam Jacobi’s syntax is complex, no one would call it conver-
sational. Its particular features require the reader to suspend the thought of
the sentence while searching for delayed head-words; the passage is closely
connected to a culture of reading printed texts. Mary Putnam Jacobi may
have been the first woman physician to write in publication rather than
simply writing for publication.
Whatever syntactic demands the paragraph makes on the reader, it is in
other respects remarkably accessible. None of the sentences is strictly tauto-
logical—all of them advance the argument—but each repeats some given
information, usually at the beginning, so that the reader must absorb only a
few new concepts at a time. The ramified arguments of Putnam Jacobi’s
more properly medical writing, proceeding through a series of negations, are
absent. She offered theoretical ideas in carefully calibrated prose, so that
theory came to readers—to use a term Putnam Jacobi would have hated—
in homeopathic doses.
The writer, then, appears not as an avuncular family counselor but as a
teacher. Putnam Jacobi seldom indulged in the hortatory flights that marked
Corson’s and Preston’s theses or Meigs’s sermon to Helen Blanque; she
warned of dangers by stating them soberly rather than by painting lurid pic-
tures of consequences. And the discourse of health has seldom been elabo-
rated with less domestic detail. Although Putnam Jacobi herself was quite
occupied with her household and wrote a detailed book about the education
of her daughter (Physiological Notes on Primary Education and the Study
of Language, 1889), her advice on helping a child establish mental health is
very general. The essay constructs its reader as someone who is aware of
the complexity of science and the vastness of the world, as someone who
understands children and who makes her own provisions for them. The
writer grounds the reader’s experience in scientific concepts rather than me-
diating the authority of science over her practice, so that the gender positions
of both reader and writer hover indeterminately. Nothing in the essay speaks
from the experience of caring directly for a child; nothing speaks to the gen-
dered experience of care-giving. Science and medicine appear not as male
provinces but as territories traversed by all enlightened citizens.
Putnam Jacobi’s medical writing had, of course, quite different aims. Her
“Studies in Endometritis,” published in the American Journal of Obstetrics
in 1885, for example, took up the question of the causes of menstruation.
Before the discovery of hormones in the 1930s, menstruation was likely to
be understood mechanically, but it raised for Putnam Jacobi the question of
how the tissues of the reproductive system, tissues which are periodically
destroyed, differ from others which continue to grow and maintain them-
selves. After reflecting on the functions of menstruation, Putnam Jacobi con-
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Mary Putnam Jacobi
cluded, “Without fantasy it may therefore be said that there is a certain an-
tagonism between the reproductive forces and the individual forces of the
organism, even at their fundamental point of junction, where the muscular
force of the uterus touches upon its reproductive capacity.” 142 She saw uter-
ine functions as episodes both in the history of the “parent organism” and in
the quite distinct narrative of reproduction. Putnam Jacobi’s text established
an interest in women’s health and well-being over an interest in their capac-
ity for reproduction; her argument unsentimentally asserted the “parent or-
ganism’s” self-interest. So thoroughgoing was Putnam Jacobi’s rejection of a
separate sphere that she wrote these paragraphs in systematically, and quite
awkwardly, gender-neutral language. The cultural fantasy of the pregnant
male haunts this passage, as if the “parent organism” were only accidentally
female.
Paradoxically, the speaker of “Studies in Endometritis” is much more
clearly available in the text than that of “The Prophylaxis of Insanity.” There,
Putnam Jacobi had asserted impersonal necessities: “study . . . often serves . . .
to detect flaws . . . too minute to notice.” 143 The endometritis essays, how-
ever, are animated by the writer’s sense of her authority; she replies confi-
dently to the chorus of established medical opinion. Putnam Jacobi took up
the venerable weapon of feminine satire, and the bracing irreverence of her
private correspondence emerged (at last) in her medical writing. Putnam
Jacobi’s review of the literature, a lament for the disorganized, pretheoretical
state of gynecology, is especially hard on a writer who asserts that all uterine
diseases are surgical and “curable by the knife alone.” In a footnote, Putnam
Jacobi names names: “Sims’ ‘Uterine Surgery,’ Is this not a singular way to
define the nature of a disease by the method used in combating it? On this
principle we could as well speak of iodine diseases, or pessary diseases, as of
surgical diseases of the uterus.” 144 Since the “Sims” named by Putnam Jacobi
was James Marion Sims, widely regarded as the founder of the prestigious
New York Hospital for Women, it is perhaps not surprising that the Obstetri-
cal Society of New York never got around to admitting Putnam Jacobi. She
had located herself in the thick of controversy, satirizing powerful figures
who would be among her readers.
Putnam Jacobi’s medical writing is enmeshed in her enjoyment of guilty
pleasures, of seeing colleagues caught out in error, or of dismissing their
“little essay.” It fosters distinctly professional pleasures of aggression and
combat within a professional community, of carefully staged and orches-
trated argument, of settling scores with professional rivals, of shuttling ef-
fortlessly from the level of the cell to the level of the species. Putnam Jacobi
associated these pleasures with the sight of the interior of the body, with the
possibility of opening to view what had been hidden, an act she had associ-
ated with pleasure from her childhood. She found ways of realizing this plea-
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Mary Putnam Jacobi
Figure 12. “Ribbon-like fibres with nucleus, from uterus eight days after delivery,” woodcut
from Mary Putnam Jacobi’s “Studies in Endometritis,” American Journal of Obstetrics 18
(1885), 813 (Photograph courtesy of the Library of the College of Physicians of Philadelphia)
sure in her medical writing. “Studies in Endometritis” was among Putnam

Jacobi’s first illustrated articles. Medical journals, of course, had long in-
cluded small inset graphics; from midcentury, woodcuts and other engrav-
ings appeared in monthly journals such as the Archives of Medicine, although
never in the weekly medical bulletins. But by 1879, images began to appear
even in the weekly Medical Record, and “illustrations” or “cuts” were com-
mon in the American Journal of Obstetrics throughout the 1880s. These
pictures might show a surgical procedure, a design for bandages or other
apparatus, a pathological specimen, or cellular structures. “Studies in Endo-
metritis” is profusely illustrated, including a score of woodcuts from micro-
scopic slides. Some illustrations were copied from other texts, but others
were apparently produced for this essay.145 The figures extend Putnam Ja-
cobi’s prose argument; they are often arranged in series to facilitate compari-
son.146 The text redundantly describes what is visible in the drawings, and
the caption often draws our attention to the same features. While Putnam
Jacobi characteristically moves her exposition briskly, her use of these new
technologies of the visible is less assured; the textual deictic is multiplied and
repeated. A drawing of long fibers is captioned, “Ribbon-like fibres”;147 the
fibers will be indicated later as “fusiform fibre-cells.” (See figure 12.) The
text gestures, repeatedly, to the inset image; devices for suturing together
these two sources of information had not been conventionalized.
Putnam Jacobi’s more immediate response to technologies of visualization
is recorded in her remarkable essay “The Practical Study of Biology,” origi-
nally an address to the Massachusetts Medical Society’s annual dinner in
1889. After arguing that a medical student must be changed in “his whole
mind” so as to “insensibly . . . blend with the phenomena they can pro-
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Mary Putnam Jacobi
foundly contemplate,” 148 Putnam Jacobi offers a personal anecdote. So un-

usual is this gesture for Putnam Jacobi that she is not at all sure how to
introduce the story: “I should like, Mr. Chairman, to mention an incident
that occurred to myself in the course of a very simple laboratory experi-
ment.” She was examining the circulation in a frog’s lungs:
I happened to so focus my lens that all the outlines of the capillaries and blood
corpuscles disappeared, leaving visible only the spaces between the epithelial
cells. Nevertheless there remained a vision of the streaming movement of the
invisible blood through the ramified spaces. The streaming was so rapid, so ener-
getic, so ceaseless, it seemed as if it were pure motion or force divorced from
the accidents of matter. The microscopic shred of tissue from the insignificant
animal seemed for the moment to give a glimpse of a mighty vision of endless
life, streaming with infinite energy into the minutest particles of an infinite
universe.149
Putnam Jacobi found this perception “indescribably powerful.” No wonder.
The ghostly image of the hidden, moving, and clearly indicated blood re-
called the intellectual energies that had animated her work; an overarching
theory (a mighty vision of endless life) joined to detailed, concrete, and pre-
cisely located physiological structures (spaces between the epithelial cells),
organized in ramifying branches and speaking above all of force, motion,
will. She repeatedly reproduced this figure for her students: “Since then I
have confronted students with this same impression,” offering it deictically
as “the horizons towards which they were henceforth to keep their eyes
directed.” 150
GENDER PERFORMANCE, GENDER TRAVESTY, AND

GENDER MOBILITY
Mary Putnam Jacobi’s performance of gender was self-conscious and experi-

mental. If Ann Preston saw her work as a physician as essentially connected
to her gender, and if Hannah Longshore continually constructed temporary
connections between received ideas of femininity and her shifting scientific
commitments, Mary Putnam Jacobi combined a steadfast refusal to essen-
tialize her gender with a steady curiosity about what it meant to write and
practice as a woman physician. Judith Butler has advanced an understanding
of gender as performative, modeled on “performatives” in speech act the-
ory—sentences which effect the action that they name, such as I pronounce
you man and wife, or You are sentenced to be hanged by the neck until dead,
or I promise I will repay this loan. In Butler’s succinct statement, “. . . gender
is not a noun, but neither is it a set of free floating attributes, for we have
seen that the substantive effect of gender is performatively produced and
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Mary Putnam Jacobi
compelled by the regulatory practices of gender coherence. Hence, within

the inherited discourse of the metaphysics of substance, gender proves to be
performative—that is, constituting the identity it is purported to be.” 151
Mary Putnam Jacobi’s apprentice medical writing was often read as the
work of a male author. At this early stage, she avoided tropes associated with
women physicians (the importance of prevention and hygiene, opposition to
the legalization and medical control of prostitution, interest in maternal and
child health) and took up issues that women physicians generally avoided
(questions of surgical technique, pathology, and medical theory).152 In pri-
vate settings, Mary Putnam Jacobi explored more indeterminate perfor-
mances of gender. Her Parisian family correspondence is a veritable anthol-
ogy of gender experiments. Putnam kept her mother posted on the state of
her wardrobe; one of the subplots of these letters is the progress of her sec-
ond silk dress, after many trips to the dye-shop, from garish cherry to decent
black with a long stop at dignified maroon. In fact, as we have seen, it was
not exactly Mary Putnam but “a petticoat” which arrived at the amphitheater
of the École de Médecine. And Putnam also noted with satisfaction every
time she was addressed or referred to as confrère, the ordinary collegial term
among French physicians, a term whose atrophied gender marking was sud-
denly rendered visible by her presence. She was flattered when one of her
teachers, a Dr. Hérard, greeted her by giving her his left hand, “the distinc-
tive salutation of a confrère!” 153 This gesture was, for her, floridly gender-
marked. After she passed her last exam, she was pleased to be greeted as
both madame and confrère,154 terms that were both, in certain senses, count-
erfactual (she was not married, she was not a brother) and in other senses
entirely appropriate (she was a mature woman, a professional colleague).
And Mary Putnam was not alone in her preoccupation with the indetermi-
nacy of a female confrère. She translated the notice of her final examination
in the Figaro: “Our confrère is among ceux—pardon the word,—celles who
define life resolutely.” 155 If the noun does not mark gender unambiguously,
then the pronoun must; but of course the war between the noun and the
pronoun renders the question of gender always salient and never decidable.
For Putnam Jacobi’s Boylston Prize essay, The Question of Rest for Women
during Menstruation, multiple audiences conserved the complexity of her
gender performance. The male selection committee who read Putnam Ja-
cobi’s anonymous essay were expected to mistake her for a male physician.
But, since her entry into the competition had been solicited by Boston femi-
nists and agreed to in principle by members of the Harvard faculty, The
Question of Rest is, to use cultural theorist Marjorie Garber’s terms, a per-
formance of marked transvestism disguised as a performance of unmarked
transvestism. Putnam Jacobi pretended to pretend to be a male doctor; some
of her initial readers would in fact have read The Question of Rest during
189
Mary Putnam Jacobi
Menstruation as a methodologically interesting discussion by an otherwise

unremarkable (male) writer, while others might have suspected that a text
which drew so extensively from women’s self-reports might be the entry that
they had themselves encouraged. They might have covertly recognized Put-
nam Jacobi’s essay as a work by a woman presenting itself as an essay by a
man; one can only speculate about the feats of pronominal camouflage they
must have performed during committee meetings, Putnam Jacobi’s conta-
gious gender disassignment having infected them. And the readers of the
published essay, for whom the writer’s gender is patent, would have read The
Question of Rest during Menstruation as an instance of the triumphant story
of the woman covered by anonymity who had bested men at their own game;
for them, the moment in which Putnam Jacobi’s transvestism was marked
and solicited has been elided. In all these positions of reading, something
about the gender of the writer is unknown or untellable. The action of a
woman writing medicine, as Putnam Jacobi performed it, is a veiled and
ironic action, uncontainable in its valence; no reader can be sure of the pre-
sented or concealed gender of the writer or even be sure of whether gender
is being presented or concealed.
Even in Putnam Jacobi’s collaboration on the Infant Diet project, no
boundary marks the transition from Abraham Jacobi’s text to Mary Putnam
Jacobi’s adaptation. In fact, the only words that the initial readers could have
assigned to a single writer are those of Mary Putnam Jacobi’s signed intro-
duction, with its reflections on the centrality of theory to popular writing.
Neither the text nor its apparatus allows gender to settle comfortably; no
particular passage can be assigned to either writer without consulting Abra-
ham Jacobi’s original address. The text continually invites us to errors: Was
Mary Putnam Jacobi responsible for the recipes? (No, they were in Abraham
Jacobi’s initial talk.) And such errors productively reveal what was expected
of the medical writer in the middle of the nineteenth century, when medical
writing was defining itself as a distinct discursive form.
As her reputation grew, Mary Putnam Jacobi had fewer opportunities to
exploit the assumption that the writer of medicine is male, but her own gen-
der performance was never simple. In her “Woman in Medicine,” for Annie
Nathan Meyer’s collection Woman’s Work in America, Putnam Jacobi pre-
sented medicine as a field, where “whatever is, invariably seeks to strangle
in the birth that which is about to be.” 156 She satirized her predecessors in
women’s medical education, who felt that “co-educational anatomy is more
easily swallowed when administered in homeopathic doses” 157 —did she ever
resist the opportunity to take a swipe at homeopathy? Seldom has the history
of early women physicians been written less hagiographically. Ann Preston
was all too pious; the early Eclectic women physicians were all too idiosyn-
cratic. Mary Putnam Jacobi’s talent for eliding herself from the scene she
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Mary Putnam Jacobi
describes, marked since her very earliest writing, does some of the work of
gender performance in “Woman in Medicine.” Since contributors to Wom-
an’s Work in America were major figures, well known in their fields, even a
reader who had never heard of Mary Putnam Jacobi would assume that she
was an active woman physician. But she leaves her own role as a medical
pioneer out of this account; we read a very detailed summary of the struggles
to admit women to the county medical societies of Philadelphia and Boston
but nothing of their early and uncontested admission to the New York
County Medical Society. Mary Putnam Jacobi mentions herself only twice:
as a founder of the Mt. Sinai Hospital dispensary, and as a member of the
faculty of a school for postgraduate medical education. With these two ex-
ceptions, both of which demonstrate Putnam Jacobi’s integration into the
upper ranks of male institutions, the history of women in medicine is written
from an Olympian height. We would never know that Mary Putnam Jacobi
had studied at the Woman’s Medical College of Pennsylvania, whose stu-
dents she dismissed cavalierly as nearly illiterate; we would never know that
she felt herself compromised by the weak preparation of early women physi-
cians. The pronouns are telling: for Putnam Jacobi, women physicians are
they rather than we or I. Her own early struggles vanish into a general
narrative:
Women students have been cheated of their time and money, by those paid to
instruct them: they have been led into fields of promise, to find only a vanishing
mirage. At what sacrifices have they struggled to obtain the elusive prize! They
have starved on half rations, shivered in cold rooms, or been poisoned in badly
ventilated ones; they have often borne a triple load of ignorance, poverty, and ill
health; when they were not permitted to walk, they have crept,—where they
could not take, they have begged; they have gleaned like Ruth among the har-
vesters for the scantiest crumbs of knowledge, and been thankful. To work their
way through the prescribed term of studies, they have resorted to innumerable
devices,—taught school, edited newspapers, nursed sick people, given massage,
worked till they could scrape a few dollars together, expended that in study,—
then stepped aside for a while to earn more.158
Putnam Jacobi’s youthful struggles have been silently assimilated to those of

Zakrzewska and Blackwell; the poverty of their preparation, their crumbs of
knowledge, are transposed into a badge of pride. But the writer of this pas-
sage is situated outside their struggle; who would have dared cheat Putnam
Jacobi of her time and money? She spoke with authority by constructing a
position beyond gender; she is not part of “them.”
Putnam Jacobi refused to essentialize women, to compound them into a
group contained in a single separate sphere. This refusal could be infuriat-
ingly self-righteous; this most favored of daughters sternly warned medical
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Mary Putnam Jacobi
students not to be swayed by the praise of their partial families: “A woman

must accustom herself to dispense with the personal approbation of the
people she knows, as a stimulus for exertion” or she will “soon cheapen with
praise.” 159 But Putnam Jacobi never reduced women to symbolic status or
referred them to any transcendent reality beyond the struggle to live in
“large liberty”:
Women have in the mass, never been publicly and officially regarded as individ-
uals, with individual rights, tastes, liberties, privileges, duties, and capacities, but
rather as symbols, with collective class functions, of which not the least was to
embody the ideals of decorum of the existing generation, whatever these might
have to be. These ideals once consigned to women, as to crystal vases, it became
easier for men to indulge their vagrant liberty, while yet leaving undisturbed the
general framework of order and society.160
Putnam Jacobi acted in common with other women, especially other women
physicians; not only did she continue political activity throughout her life,
but also she urged women physicians to act collectively. In her 1883 com-
mencement address at the New York Infirmary, she admitted that she had
urged her students to see themselves first as physicians and then as women:
“Recently emancipated people are always bores, until they themselves have
forgotten all about their emancipation.” 161 But, Putnam Jacobi conceded,
deliberate amnesia had its limits; women physicians have faced a “bitter,”
“brutal,” “densely organized,” “versatile,” and “incomprehensible” opposi-
tion and should act on the basis of a “close solidarity of interests.” 162 For
Putnam Jacobi, gender identification was based on a common experience of
oppression and enacted in the project of dissolving that experience. It is not
surprising that Putnam Jacobi’s final advice to these graduates was a gnomic
reduction of her own practice of gender performance: “You must, on the one
hand, forget that any social prejudices stand in your way as physicians: but
on the other hand you must remember that, in virtue of these, you continue
to have certain class interests, which can not, with either justice or safety, be
ignored.” 163 Just so, Mary Putnam Jacobi constructed for herself a world in
which the difference between physician and lay person was more salient and
pressing than the difference between man and woman; she recognized that
hers was a constructed world, one in which, in her phrase, horrors were
“overcome or transformed by the potency of the Ideal,” whereas in life they
could only be “borne unrelieved” or undermined by a skillful and destabiliz-
ing rhetoric.164
192
7
Forbidden Sights
Women and the Visual Economy of Medicine
THE CLINICAL LECTURE
On November 6, 1869, a small group of students from the Woman’s Medical

College quietly entered the new amphitheater of the Pennsylvania Hospital
and took seats together.1 Their entry into these clinical lectures was a wel-
come turning point in the college’s struggle for acceptance. The Philadelphia
County Medical Society had recently passed its most punitive resolution
against the Woman’s Medical College, barring from membership graduates
of the women’s college, professors at the college, and those who consulted
with them. The Woman’s Medical College had been declared a pariah insti-
tution. Although the women faculty of the Woman’s Medical College had
repeatedly petitioned for admission to Pennsylvania Hospital’s clinical lec-
tures, beginning with a letter from Ann Preston in 1855, the managers only
agreed to their request on October 25, 1869.
The institution the women students entered was central to the teaching and
practice of medicine in Philadelphia. The Pennsylvania Hospital was the old-
est and best known Philadelphia hospital, entrusted particularly with the care
of accident victims. Although it was called the Quaker hospital and most of
the managers were Quakers, Pennsylvania had no official connection with the
Society of Friends. The heroic painting given to the hospital by Benjamin West,
Christ Healing the Sick, expressed the ideology of the institution: healing is
a divine work, undertaken in public for the benefit of the grateful people.2
Clinical lectures at the Pennsylvania Hospital were given by the attending
staff of the institution. Like the house staff of other American hospitals, they
battled for control of the institution for decades; the issues of hospital admis-
sions and releases, of student access to patients, and of free and paying pa-
tients were all contested. Managers, responsible for the overall management,
solvency, and good repute of the hospital, insisted on the right to screen
patients for their moral fitness and desert, to restrict student access, and to
control finances. They organized their own work meticulously, fining each
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Forbidden Sights
other for absences from meetings and providently organizing appeals for
funds; they expected the same sober and businesslike behavior from the
medical staff. (It is far easier to trace the records of decisions made by the
board of managers in 1897 than it would be to trace those of, say, a twentieth-
century academic department.) The hospital’s attending doctors, however,
wanted greater professional control over patient care, particularly hospital
admissions, and greater student access to patients; the lay control of the hos-
pital compromised their professional discretion.3
Although the Pennsylvania Hospital did not sponsor a medical school, its
lectures were eagerly attended by students from Philadelphia’s university
and proprietary medical schools throughout the early decades of the nine-
teenth century.4 Schools required students to show their tickets for hospital
lectures, the sole clinical education required of a mid-nineteenth-century
physician. Tickets were moderately priced, and the Pennsylvania Hospital
donated the proceeds to its medical library, which was open to students. And
the purchase of tickets could be a formality. Students were not examined on
what they had seen; they might purchase a variety of tickets for different
hospitals and attend whichever lectures proved interesting, or none at all.
Many students, however, attended lectures regularly, sometimes at more
than one institution, and kept careful notes on what they saw. In Philadelphia
during the 1860s, clinical lectures would have been offered not only at the
Pennsylvania Hospital but also at Jefferson, the Philadelphia Hospital asso-
ciated with the Philadelphia Almshouse, called the Blockley, and in clinics
attached to the University of Pennsylvania School of Medicine. Smaller, spe-
cialized hospitals sometimes offered clinical lectures, including, of course,
the Woman’s Hospital associated with the Woman’s Medical College.
Conventionally, lectures in medicine and surgery were scheduled for suc-
cessive hours; two different lecturers publicly examined patients they consid-
ered interesting. In the surgery clinic, operations were performed on a table,
often a revolving table, in the center of the amphitheater; at medical clinics,
the patient would be treated, given medicine, and sometimes told to return.
Students themselves do not seem to have had an opportunity to examine the
patient or to ask questions. Notes of clinical lectures show five to ten cases
being demonstrated in an hour of medical clinic; surgical clinics would fea-
ture as many operations as could be undertaken in the allotted time, with
running commentary by the surgeon.
At the Pennsylvania Hospital, the clinical amphitheater was itself a dra-
matic space. It was at once intimate (any word spoken in the amphitheater
could be heard throughout the room) and ceremonial (a newly dedicated,
splendid structure, an octagonal room with deeply raked banks of seats, lit
by eight double windows and a skylight).5 The median space of the amphi-
theater was a freestanding building, connected to the hospital only by a cov-
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Forbidden Sights
ered corridor. The clinical amphitheater connected the academic, physician-

controlled world of the medical school to the institutional, lay-controlled
world of the hospital. The hospital managers chose the lecturers, but lectur-
ers chose the clinical “material.” The audience included students from many
different schools, both regular and irregular: the homeopathic Hahnemann
Medical College normally sent students to the Pennsylvania Hospital lec-
tures, and male students came from the Eclectic and coeducational Penn
Medical University, founded by the redoubtable Joseph Longshore. (Women
students from Penn Medical University petitioned for admission in 1855 and
were summarily denied.) But while the audience was varied, it was never lay.
As J. Forsyth Meigs put it in his lecture inaugurating the new amphitheater:
Let it not be forgotten, too, that this demonstration is never made to a promiscu-
ous, or rude, or gaping public audience, who might assist at such a spectacle
from mere vulgar curiosity. It is made only to those who belong to the same
vocation or guild as that to which belong the surgeons and physicians of the
house, and but for whom this Hospital could not exist, and who, themselves, but
for like opportunities in the past, could not have had that exact knowledge and
experience whereby these very patients now profit.6
The clinical amphitheater is constructed as a site for the generational trans-

mission of knowledge; the amphitheater forms the physician, who then fil-
ially supports the amphitheater. Such a transmission assumes an identity
between the surgeons and physicians of the house and those who belong to
the same profession. Since the amphitheater replicates the exact knowledge
and experience taught in the past, the physician reproduced through its
spectacles must be identical to the physician who presents patients: the male
doctor demonstrates his craft to the male medical student.
In 1869, the managers of the Pennsylvania Hospital interrupted that trans-
mission, reasoning that since the Woman’s Medical College of Pennsylvania
had been chartered by the state, its students met the criteria for admission
to the “common benefits of the Hospital clinical instruction.” 7 Tickets were
duly proffered and purchased, and a group of women medical students,
numbering somewhere between thirty and thirty-five, accompanied by a
woman from their faculty, came into the amphitheater.8 Male students stood
in the tiers above them, passing remarks, reading aloud from their notes,
and, by some accounts, spitting tobacco on their skirts. Although many stu-
dents told reporters that they had been surprised at the entrance of women
students into the amphitheater, the day before someone had passed the
medical student Marcus Corson a note reading, “Go tomorrow to the hospi-
tal to see the She Doctors.” 9 Students hissed the two hospital managers who
sat on the amphitheater stage to forestall trouble, the traditional Quaker Wil-
liam Biddle and A. J. Derbyshire, a trustee of the Woman’s Medical College
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of Pennsylvania.10 When Biddle took the stage with his head covered, stu-
dents chanted, “Hat! Hat! Hat!” Their mocking chant spoke of the distance
between the lay managers and the students, ignorant or disrespectful of the
Quaker custom of refusing to bare the head. The arrival of the women medi-
cal students demonstrated that the Pennsylvania Hospital was already a di-
vided institution. When the chant subsided, the students settled into the
first, medical, hour of clinical lectures, led by Dr. Jacob Da Costa, which
went off without incident.11 The second, surgical, hour was more tumultu-
ous. Dr. William Hunt began his lecture by addressing the “gentlemen,”
obliquely condoning the male medical students’ harassment by ignoring the
women in his audience. (Twenty-four years later, another Woman’s Medical
College student would hear a much older Dr. Da Costa beginning his Penn-
sylvania Hospital lectures with “gentlemen.” 12 ) One account, in the Philadel-
phia Evening Bulletin, tells that Hunt tested the eyesight of a patient by
pointing toward the women medical students and asking the patient what he
saw: “Said the Professor, ‘Look up! Look higher, and tell me what you see.’
The man strained his almost sightless eye-balls and replied, ‘Light! I see
light!’ and nothing more would he acknowledge.” The Evening Bulletin
found in this remark a recognition that “light” was “dawning upon bigotry
and oppression.” 13
The incident escalated from jeering harassment to riot, however, when a
male patient was exposed to the sight of the women students. The New York
Tribune gave the fullest account:
The attendants brought forward a man with a broken thigh. This was a particu-
larly interesting and melancholy case; for the fractured bone had refused to
unite. The poor fellow was placed recumbent on the revolving couch, and the
young doctors proceeded to pull off his boots. At this, a quick, low stamping,
like a growl of dissent, ran round the benches. But “off, off, ye lendings” was
the rule, and speedily the natural, unsartorial man lay before us. The Doctor
had, however, prepared a blanket for the nonce, with which the patient was
draped. But in this chamber the surgeon means business; and at times the deco-
rous conventions must shrivel up before the needs of science and humanity. In
this case, while measuring the fractured limb, there was a momentary exposure,
which proved the signal for an explosion among the students.14
This exposure has been theatrically performed: ornamented with a quote

from King Lear, set on a revolving couch (a feature of the amphitheater since
at least the sixteenth century), and presented in stages (boots, a blanket,
nothing). The patient’s leg appears as a disembodied “part,” fleetingly, in a
“momentary” transformation of the patient. At least one observer felt that it
was this staging, rather than the exposure itself, that was provocative:
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If a blanket accidentally falls off partially during an examination of a fractured

thigh, to jerk it back again with an air of embarrassment may cause a painful
flow on the cheek of a very young gentleman or excite the cachennation of a
somewhat older blackguard, when women are present; but its proper removal
entire, under the requirements of the case, could never call a blush to the brow
of either man or woman worthy to be allowed entry to a sick room.15
The women were hooted at; there was a storm of hissing and thrown objects.
Again, the lecturer did not notice the women students or attempt to restore
order, but continued his presentation and left the stage without comment at
the end of the lecture.
As the women prepared to leave the lecture hall, the turmoil of the clinical
lecture spilled outside and quickly became public. Because the hospital was
centrally located, students exiting from the amphitheater were at once on
the street, at midday, in a very busy place. By most accounts, male students
formed two rows along the path from the amphitheater to the street and also
along the street leading away from the building.16 The women students had
to pass through this gauntlet as they left the amphitheater. The male students
jeered at them and perhaps followed them on the street; writing many years
later, the Woman’s Medical College student Elizabeth Keller said that “we
were actually stoned by those so-called gentlemen.” 17 Although some male
students claimed that they were curious rather than hostile, no eyewitness
felt that the scene was peaceful. Widespread press coverage of this event
was critical of the male medical students: their conduct was a sign of narrow-
minded opposition to women physicians; it continued the medical student
rowdiness that had plagued antebellum Philadelphia; it was a simple riot.18
Physicians, however, saw the jeering incident differently. The medical fac-
ulties at the University of Pennsylvania and at Jefferson virtually endorsed
the actions of the male students, claiming that their response to the women
students was justified, complaining that all the students were being blamed
for the actions of a few hotheads, and supporting the student boycott of fu-
ture mixed clinical lectures.19 The medical staff of the Pennsylvania Hospital
saw the managers’ decision to admit women into the clinical lectures, taken
without consulting them, as an abridgment of their prerogatives. When the
women students announced their intention to attend further lectures, even
the liberal medical press felt they were being provocative.20 At the next lec-
ture, the only male students in attendance were from the Penn Medical Uni-
versity and the homeopathic Hahnemann.
A petition against the attendance of women at mixed lectures circulated
among physicians; its 283 supporters included not only the usual conserva-
tives, Agnew, Gross, and Meigs, but also “scientific” physicians like Leidy
and Mitchell, along with Alfred Stillé, who himself lectured to mixed audi-
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ences at the Blockley. The Philadelphia College of Physicians passed resolu-

tions supporting the medical staff of the Pennsylvania Hospital, urging that
justice and courtesy required that they be consulted in the management of
hospitals and opposing any change in “the system, established by long usage
and general consent, of giving clinic instructions.” 21 The medical staff of
the Pennsylvania Hospital asked the managers to accept their delegate as a
member of the board.22
Dean Ann Preston and the faculty of the Woman’s Medical College pro-
tested that they had no intention of intruding into inappropriate clinical lec-
tures. The women would attend only one day a week, when cases suitable
for demonstration to a mixed group could be chosen.23 The managers of the
Pennsylvania Hospital, meeting on November 13, 1869, declared themselves
surprised by the controversy, given the mixed clinics at the Blockley, as well
as at Bellevue, Edinburgh, and Zurich. But they appointed a committee of
five to plan separate clinical instruction for women. Still, surgeon D. Hayes
Agnew was so offended by the thought of lecturing to women, even in segre-
gated clinics, that he resigned and took an appointment at the University of
Pennsylvania.24
In the short run, the dispute over women students’ attendance at the
Pennsylvania was resolved in a compromise. The medical staff agreed to
admit the women students to one lecture a week. They established an elabo-
rate protocol for cases “deemed by the lecturer indelicate or improper.” The
women students would be given an opportunity to withdraw; if they did not,
the lecturer was allowed to dismiss the class. After discussion, the medical
staff agreed that if female modesty did not prompt the women students’
withdrawal, class simply would be dismissed.25 The protocol speaks not only
of a need to regulate the presence of women but of a panicked recognition
that the normal constraints of polite society would not effect such regulation.
Since the simple reproduction of male physicians had been disrupted, the
whole economy of the gaze was in question, and the medical staff responded
with a fever of regulation.
The controversy dragged on through the spring, when the managers asked
the annual meeting of Pennsylvania Hospital contributors for guidance.
Pamphlets, widely attributed to members of the medical staff, urged the con-
tributors to set aside the action of the managers and to remove the present
members of the board.26 The contributors agreed, after discussion, that
mixed lectures were inappropriate but urged the hospital to “arrange for
appropriate, thorough clinical instruction . . . to the students of the Woman’s
Medical College of this city.” 27 Separate lectures began in 1871 and contin-
ued for a number of years, although the faculty protested, at least once, that
this troublesome obligation should be curtailed. The Woman’s Medical Col-
lege faculty professed themselves content and dissociated themselves from
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a group of women students, possibly from the Penn Medical University, who
entered the amphitheater in 1871.28 The separate lectures were interrupted
for a time but were reestablished in 1875.29
In conventional medical history, the jeering incident is an episode in the
story of growing professional control of hospitals. Although it is unclear that
representation on the board of managers immediately increased the relative
power of the medical staff, public controversy over the incident seems to
have chastened the lay managers more than it did the staff physicians.30 In
feminist medical history, the Philadelphia jeering incident is an example of
the harassment women medical students faced upon their entry into mixed-
sex spaces of instruction. The jeering incident is also, I would argue, a dem-
onstration of the place of women in the visual economy of medicine and of
the disruption of that economy that women physicians effected.
Feminists writing about science, and particularly about medicine, have
often described the scientific gaze as objectifying, reifying, and quintessen-
tially male.31 In the scientific imaginary, the masculine gaze penetrates an
object, such as Nature, Life, or the Body, which has been constructed as
female. Since Bacon, sexual conquest has been a powerful figure for that
gaze; since the pioneering work of Evelyn Fox Keller, feminist students of
science have demystified science’s pose of objectivity and gender neutrality
by considering how its imaginary structures are gendered. To investigate the
story of medicine historically, however, is to encounter another gaze, that of
the woman physician, absorbed in the pleasure of doing scientific work and
most particularly the pleasure of seeing the exposed, or even dissected, body.
That gaze is understood, by women physicians and their supporters, as pro-
ductive of knowledge, of pleasure, and of a certain kind of care; the represen-
tation of the exposed or opened body is, in many ways, a textualization of the
body alternate to that produced in medical writing. The medical spectacles
that nineteenth-century women sought to witness were demonstrations that
the body could be understood and treated; they mapped out a formerly un-
known terrain and reduced it to a named and understood territory.
The clinical lecture, as a ceremony of patrilineal succession, was a key site
for mapping the body; women seldom entered this space without contro-
versy. Nineteenth-century medicine depended on an economy of the visual
in which women were to be seen by physicians. While women saw quite
enough of the body and of medical treatment as nurses and sickroom atten-
dants, they were not themselves to see the body as the object of scientific
knowledge. Most of all, they could not be seen as seeing; they could not be
authorized witnesses of the scientific rationalization of the body.
Any disruption of this economy of the visual was controversial. When the
Harvard medical faculty admitted Harriot Hunt to medical lectures in 1851,
students protested:
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Resolved, That no woman of true delicacy would be willing in the presence of

men to listen to the discussion of the subjects that necessarily come under the
consideration of the student of medicine.
Resolved, That we object to having the company of any female forced upon us,
who is disposed to unsex herself, and to sacrifice her modesty, by appearing with
men in the medical lecture room.
Resolved, That we are not opposed to allowing woman her rights, but do protest
against her appearing in places where her presence is calculated to destroy our
respect for the modesty and delicacy of her sex.32
After this student resolution, the faculty withdrew its concession to Hunt and
explicitly excluded women from the medical school. The Harvard resolution
established the themes generally invoked to excuse the harassment or exclu-
sion of women medical students: for a woman to hear what medical students
heard would be monstrous; no true women could bear it. The women medi-
cal students, then, must be females (rather than ladies) in search of sensa-
tion, people with whom medical students should not associate. The Harvard
resolution ends with the infuriating concession that women’s rights are cer-
tainly to be “allowed”; opponents of women’s medical education often af-
firmed their support for women physicians, to be educated, one assumes, on
a different planet.
Philadelphia had already seen its share of such events. In 1856, women
students entered the surgical lecture of D. Hayes Agnew—the same profes-
sor who later resigned from the Pennsylvania Hospital to avoid teaching
women—at the Blockley. A nude male patient was brought on stage, and
the women students were bitterly harassed. When they persisted, Agnew
petitioned the hospital board to bar women from further attendance.33
Women did not return until 1869, when they were welcomed by Dr. Alfred
Stillé. (Stillé later, as president of the American Medical Association, fought
the admission of women, but he also served as an examiner at the Woman’s
Hospital and refused to comply with the Pennsylvania County Medical Soci-
ety’s ban on consultations with women.)
New York City women physicians responded to publicity about the Penn-
sylvania Hospital jeering incident with accounts of grotesque harassment
upon their entry into the clinical lectures at Bellevue.34 The patients, prison-
ers from a local jail, were crudely exposed and subjected to surgery without
anesthesia. Even when an institution agreed to coeducation, women might
be segregated in the clinical lecture. When the University of Michigan ad-
mitted women, they attended separate clinical lectures at the request of fac-
ulty; in 1881, the separation had diminished to a curtain or even a red line
down the classroom floor.35
Similar scandals would take place abroad. In Canada, women medical stu-
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dents at Queen’s University, Kingston, were put in an adjacent alcove “for

awkward lectures”; they were harassed by the physiology professor, and left
in protest after one outburst in 1881. The men demanded the expulsion of
women, under the threat of a mass transfer to Trinity Medical School in
Toronto. The Queen’s University administration agreed to stop admitting
women medical students, although those already matriculated were allowed
to graduate.36 A similar dispute over the exclusion of women anatomy stu-
dents from Surgeons’ Hall in Edinburgh had led to a riot in 1870. When the
five women students, led by Sophie Jex-Blake, arrived at the Surgeons’ Hall,
they were trapped in the courtyard, jostled, pelted with mud and rotten veg-
etables, and abused with foul language. Inside the lecture room, there was
continued harassment; a sheep was pushed into the amphitheater. Jex-Blake,
not the most conciliatory of the early women physicians, accused a profes-
sor’s assistant of inciting the riot. She was sued for libel, lost, and fined a
farthing. But Edinburgh was not to admit women medical students until the
First World War.37
These events confirm that women’s entry into medicine required a re-
alignment of complex economies of medical vision; it was a question not only
of women doing the work of medicine but also of women seeing the work of
medicine, and especially of women being seen by men to see the work of
medicine. Those economies were disrupted by women’s own very strong de-
sires to see, particularly to see the interior of the body. We might also re-
member Mary Putnam Jacobi, in “Practical Study of Biology,” rapt before a
microscope,38 and Anna Wharton’s 1856 account of one of Ann Preston’s
popular physiological lectures:
There were several pictures of the human body in different positions hung up,
a skeleton and a figure in the middle, or nearly so, of the platform, covered over
with a chintz bag. This was exposed to view after some preliminary remarks from
Ann and proved to be one very well calculated to illustrate the ideas she wished
to convey. It was soon turned inside out, that is taken to pieces, and exhibited
and explained. I liked the lady’s manner and ease, and was very much interested
in what she communicated, but I knew most of the things she told us about.39
The “figure” was probably a papier-mâché model made in Europe. Such

models, unlike the prohibitively expensive recumbent wax models, were in-
tended for the use of medical students as low-budget supplements to dissec-
tion.40 The organs were nested and detachable, as in the wax model, but they
could withstand heat and handling and were numbered, referring students to
a list of anatomical features. The Woman’s Medical College announcements
boasted that the school was well supplied with papier-mâché models, and
Wharton’s account demonstrates that they were a novelty. Normally the most
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fluent of correspondents, Wharton cannot quite find the syntax for a three-
dimensional figure with detachable parts; she borrows from sewing, turned
inside out, and finally settles on the mechanical taken to pieces. Unlike the
skeleton or the “several pictures of the human body,” the three-dimensional
model, with its illusion of the body cavity opened to view, is considered sensi-
tive and must be screened with domestic chintz until the audience is prop-
erly prepared. The practice of opening implies a decorum of covering.
Such spectacles and others like them—the public dissection of a brain or
the display of “a colossal ear, capable of dissection,” by the Ladies’ Physiolog-
ical Society of Boston, the microscopic soirées organized by the Woman’s
Medical College—spoke of the intense interest among nineteenth-century
audiences, particularly audiences of women, in seeing what was hidden, and
particularly the interior of the body.41 Women wrote enthusiastic letters
about these spectacles, which could be repeated informally at home. Sarah
Mapps Douglass wrote to Rebecca White, a member of the Woman’s Medi-
cal College Board of Lady Corporators, about a woman who took up a skull
and a book of lectures on physiology and “hunted for the place where the
eyestrings (muscles) where fastened. She then explained several things con-
nected with it quite satisfactorily to me and to the wonder of her compan-
ions.” Douglass herself earned $3.50 lecturing on the circulation of the blood
to “38 deeply interested women” and enjoyed Ann Preston’s lectures, ex-
claiming, “I cannot describe the pure intellect and enjoyment they give me.” 42
Barbara Stafford has brilliantly analyzed the formation of this desire to see
what was hidden in the eighteenth century, tracing the connections among
new technologies of graphic reproduction, intellectual disciplines of analysis,
and such diverse images as caricatures, directions for the reproduction of
intaglioed jewels, and Piranesi’s etchings of Roman ruins. Conventions of
medical illustration such as the opening and folding back of external tissues
to reveal interior organs, the multiplication of images of the same feature in
order to show it in various stages or conditions, and the practice of sketching
specimens from one’s own investigations were influential in domains remote
from medicine. The medical image—opened, multiplied, bearing the marks
of direct investigation—had already trained the vision of generations of the
privileged readers with access to anatomies. Disciplines associated with
medical display of the body had developed and popularized the central intel-
lectual operations of abstraction and criticism, presenting these forms of
mental work as practices productive of moral harmony and aesthetic plea-
sure. It is no wonder that, for many men and women in the nineteenth cen-
tury, the display of the body or of models, skeletons, drawings, slides, or wax
castings representing the body in the context of instruction was a particularly
privileged scene.43 Physiological instruction was understood as scientific,
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moral, and parental; it was not prurient but virtuous to learn about the struc-
tures of the body; it did not endanger a woman’s purity but informed her
maternal care.44
Images of the interior of the body in nineteenth-century culture were not
so widely dispersed as they have become for us. Although popular texts in
anatomy and physiology were cheap, available, and often consulted, such
information was concentrated rather than distributed widely in the culture.
Unlike contemporary news media, laden with cell diagrams and schematics
of bodily organs, nineteenth-century newspapers and illustrated magazines
did not include images of the interior of the body, although specifically physio-
logical textbooks and anatomical atlases could be illustrated with engravings,
lithographs, and mezzotints of dazzling beauty and complexity. Until late in
the century, when new printing processes made illustrations cheaper, even
medical journals were very sparsely illustrated. Though many nineteenth-
century medical students would have learned to draw, they seldom made
their own sketches of the structures they had been shown in lectures or clin-
ics. Medical students never included sketches of organs or structures in their
theses but instead wrote out laborious descriptions, specifying locations, at-
tachments, sizes, orientations, and colors. While medical images were any-
thing but ubiquitous, they were available, and those who were interested in
them found ways to view them, subscribing to health-oriented periodicals
and lay physiological lectures or attending meetings of physiological groups.45
But the desired demonstration could easily become the dreaded exposure,
as in the nineteenth-century medical horror story of the exposed maiden.
This story appears in a number of contexts, with greater or lesser realization
of detail. It reemerges in the context of the Philadelphia jeering incident; it
is essentially a story of a disruption in the economy of the gaze. In the midst
of the jeering controversy, a letter to the editor of the New York Herald
Tribune, signed “A Mother,” told the story of attending a clinic “in one of
the largest hospitals of the country.” She described the examination of a
young woman patient with rheumatic fever, remarking on the neatness of
her clothing and bedding.46 The woman was examined, showed her tongue,
and responded to questions:
Watching her steadfastly from the very beginning, I had seen no motion nor sign
of life, no curiosity in her face, no sidelong glance from her eye, nothing but an
absolutely marble face and eyes fixed on the bed. Judge then what must have
been my feeling when the Professor, in closing, said, “We will now notice
whether there may be a fine red rash on the abdomen,” and without a word of
permission or warning, he turned down the clothing of the bed to the middle,
and raised the entire clothing of the patient toward her neck, while he looked
closely for the rash which he observed was not there, and which, in the nature
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of the case, would not have been visible a single yard off. I did not look at the
bared body, nor even scan the faces of the crowd, which latter I should like to
have done. My eye was fixed on that pale face, and suddenly I saw waves of
crimson sweeping round and round from chin to brow in quick successive
flashes, wave after wave until the ordeal was past, and then I saw such a pallor
settle on cheek and lip as made my heart stand still with awe.
This long quotation demonstrates a quite intense and remarkable web of

identification connecting the spectator in the amphitheater and the patient,
the most vividly realized character in this drama and the source of the shame
that both writer and reader are invited to share. The writer observed the
symptoms of shame just as the physician observed symptoms of illness. At
the same time, the letter is itself an act of exposure, not only of the patient,
whose case has now been circulated, albeit anonymously, in the press, but
also of medical education. The amphitheater, after all, was not exactly a
public space; although everyone knew that patients were examined publicly
there, only doctors and students were normally admitted to the examination.
But the general public enters the amphitheater with “A Mother” to see a
medical education that brutally disregards the feelings of patients.47
Many writers responding to this letter thought that such an exposure
would not have happened if women had been in the audience; others
thought that it might still have happened and would have been even more
shameful. These speculations are especially remarkable because they assume
an exclusively male audience, even though the account is clearly written by
a woman, and because it is quite likely that women medical students were
actually in attendance at the clinical lecture where this event occurred. The
story reorganizes the patient’s body from the tableau of sickness, packaged
on the cot, immobile and unitary, to a set of segmented parts, each of which
displays a sign, the “minute rash” or the hectic blush. The patient is no longer
available as an object of identification and care but becomes instead a site of
instruction and labor. In the account of “A Mother,” this transformation is
phrased as a choice between gazing at the face and gazing at the stomach:
the mother sees the face but not the stomach; the students see the stomach
but not the face. The medical gaze erases female subjectivity, which can be
restored only by a gaze that erases the body.
A cognate story was told by Dr. Emily A. Varney-Brownell in her autobio-
graphical case history, “A Case of Hemoptysis.” 48 Varney-Brownell argued
that her initial attack of hemoptysis (spitting blood) was brought on “by a
severe nervous shock, occasioned by insults, and ill treatment, from the male
medical students at the Blockley in Philadelphia.” She dated the event in
1854 and describes “silence soon broken by hisses and cheers” that greeted
the four women students at their first appearance, followed by an escalating
series of harassments, ending “in gross insults, such as the holding up to their
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view, on the end of a walking cane, a rag baby in miniature; and taking an
imbecile by the arm and marching him up the aisle in a state of nudity.”
None of these exhibitions truly disturbed Varney-Brownell until a male stu-
dent took a seat behind her and placed “his arm across the back of her chair,
gradually bringing it nearer until it touched her back.” She indignantly asked
him, “Will you please move your arm, sir!!” but the “strain upon her nervous
system” caused a hemorrhage of the lungs. For Varney-Brownell, harass-
ment was an attempt to disorganize women’s sight by offering them spec-
tacles which were (somewhat stupidly) transgressive; the gaze, however,
eventually gave way to touch, a violation of boundaries that catastrophically
disorganized her body.
Other women responded differently to the exposed body of a patient.
Mary Pratt, M.D., refuted “A Mother” in a letter to the Herald Tribune. This
Woman’s Medical College graduate attended the clinic described in the “A
Mother” letter; she identified it as the Blockley’s.49 Pratt pointed out that the
very affecting details of the patient’s neatness and cared-for appearance were
signs that she had been treated well, since she could not have done such
things for herself. The doctor exposed the patient, Pratt explained, because
he had found a symptom of typhoid and therefore was obligated to search
for other signs of the disease. But Pratt insisted that “in so doing, he did not
bare that woman’s body to the atmosphere of that room.” And she turned
the Mother’s segmenting gaze back upon her: “The writer says: ‘I did not
look at the bared body; my eyes were too intently fixed on the pale face.’
How then did she know that the body was bared?” Pratt later visited the
patient herself and found that she did not remember any of the details re-
counted in “A Mother” but appreciated her doctor’s devoted care. Pratt con-
cluded, “So you see the flushing and paling, the sinking and nerving, of which
the writer speaks must have had their origin in her own morbid imagination.”
Pratt criticized the Mother’s logic of identification, foregrounding her role
in the triangular exchanges of gaze and object. The gaze of the Mother on
the face of the patient signified not steadfast and devoted care but a form of
inattention, an inability to appreciate the medical questions at issue. A brutal
and gratuitous display becomes a disinterested inquiry; the Mother’s gaze
promises not succor but shame; the morbid imagination of the writer pro-
duces exposure. It is as if Stendhal had been rewritten by Flaubert; all the
inflamed language of social exposure, the whole presence of the palpitating
body, has been transformed into a dry and satiric recitation of symptoms, in
which the chief source of infection is found to be the reader.
In this vexed economy, the gaze of a woman was sometimes felt to be a
benign corrective. Her powers of sympathy would stabilize the uncertain
energies of the medical spectacle. Charles Reade’s fictional woman physi-
cian, Rhoda Gale, describes a mixed clinic where women medical students
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hung back during the examinations of male patients but “did crowd round
the beds of the female patients, and claimed the inner row: AND SIR,
THEY THANKED GOD FOR US OPENLY.” 50 In the same spirit, many of
the comments on the jeering incident speak of the women medical students’
moderating influence on the Blockley lectures and at Zurich.51 Similar argu-
ments on the edifying effect of women spectators emerged in earlier contro-
versies, such as that over Elizabeth Blackwell’s presence at anatomical lec-
tures. She saw her attendance at the more delicate lectures on anatomy as
“the real test of the influence of a woman upon the conduct and character
of a man in co-education,” especially since the professor was
a rollicking, jovial man, who constantly interspersed his lectures with witty re-
marks and funny anecdotes. Nor did he study to have his language chaste, or the
moral of his stories pure and elevating. In fact, vulgarity and profanity formed a
large part of his ordinary lectures; and especially was this true of the lectures
on the branch of anatomy above mentioned. On this account, chiefly, he was
exceedingly popular with his class; and during his lectures stamping, clapping,
and cheering were the principal employments of the students.
Blackwell wrote a note to the professor, arguing that she should attend the
anatomical lectures, fearing no impropriety, since the study of medicine
could not fail to make all doctors reverent. Professor and students agreed to
her attendance, and the lectures on anatomy that followed were unusually
comprehensive and thorough.52
For other observers, the presence of a woman in the audience at a clinical
lecture transposed it from a scientific ritual to a sensational spectacle. For a
medical student interviewed by the Philadelphia Press, even exposure at the
Blockley was too much: “Q. Women are present at the clinics held at the
Blockley Almshouse, are they not? A. Yes, sir; the laws of this institution are
such that a patient is obliged to expose his person, consequently the effect
has been to shame the modesty alike of the surgeons and male students. The
women have their own hospital; why not let them attend it?” 53 The Pennsyl-
vania Hospital was a much more respectable civic institution, and students
there would be disgusted by the presence of “young women who could gaze
at, unmoved, and perhaps handle objects of the most repulsive kind, some
of them evidences of disease resulting from vicious and criminal indul-
gences, and requiring for their exhibition unseemly exposure of the person of
the patient.” 54 The same visual economy structured the story of the exposed
maiden and the jeering incident; to see a patient was, in some sense, to be-
come that patient—in the imagined case, an immoral patient whose disease
was his own fault. Identification quickly becomes contagion, and the pres-
ence of a woman spectator breached the gender decorum that contained it
within the story of professional reproduction.
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In its “Remonstrance against Mixed Clinics” the Philadelphia medical es-

tablishment implicated itself in this economy. The “Remonstrance” was, in
effect, the official medical response to the jeering incident. It was silent on
the actions of the male medical students but eloquent in its denunciation of
the mixed clinics. Such clinics violated the modesty of male patients: “It can-
not be assumed, by any right-minded person, that male patients should be
subjected to inspection before a class of females, although this inspection
may, without impropriety, be submitted to before those of their own sex.”
Such exposure would strain and embarrass the lecturer, and instruction
would suffer. In cases of surgery, the “Remonstrance” continued, the stakes
were even higher:
In many operations upon male patients, exposure of the body is inevitable, and
demonstrations must be made which are unfitted for the observation of students
of the opposite sex. These expositions, when made under the eye of such a con-
joined assemblage, are shocking to the sense of decency, and entail the risk of
unmanning the surgeon—of distracting his mind, and endangering the life of
his patient.
The “Remonstrance” ends by warning—appropriately, it seems—that the

attendance of women at mixed clinic would break down the “barrier of re-
spect” between men and women.55
Here again, the presence of women destabilizes the visual economy of the
amphitheater. The mixed audience is referred to as a conjoined assemblage,
recalling the body as it is presented in surgery, as a layered congeries of parts.
The lecturer’s demonstration, his “exposition,” is also a “shocking” exposure,
so that the sense of a dangerous spectacle moves from the lecturer, to the
exposed patient, to the listening assemblage. And, with the candor that
marked so many nineteenth-century discourses of gender, such exposure is
identified as a danger to the manhood of the lecturer, the only security for
the life of the patient. Seldom have the relations among gender, knowledge,
and control been more baldly stated. Only the identification between the
urbane lecturer and his male students contained the suffering patient as ob-
ject of knowledge. The presence of women students raised the terrifying
possibility that the viewers of the spectacle could themselves become objects
of a cool, surveying gaze. A woman who could engage in such an action must
herself be lost to modesty, or, as one writer put it, the women students “dis-
robed themselves, on this occasion, of the attractive and even protecting
vesture of modesty and shrinking reserve from all needless exposure, and
chose to appear in a state of demi-moral nudity.” 56 Such exposure excused
anything: harassment on the street, jeers, catcalls, even, at other times and
places, the sad carnival of naked men paraded into the amphitheater and of
sheep among the benches, even the grotesque Bellevue incidents. Once the
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Forbidden Sights
economy of the gaze had been disrupted, no other boundaries held, not the
boundaries of the body or the differences between human and animal, be-
tween medicine and torture. The women medical students had themselves
become spectacles and took refuge in their status as impassive members of
the audience, offering their own professional decorum, a performance of not
being on display: “The eyes of half the audience were on the lady students
who sat calm and unruffled under this brutal treatment, their looks riveted
on the lecturer, as if utterly oblivious of aught else that was transpiring.” 57
For the women medical students, the humiliation of being seen, being
gazed at, could be rectified only by a redirection of the spectacle in which
the male medical students were themselves exposed and held up to scorn. It
is remarkable, but probably not accidental, that three scrapbooks survive in
the papers of the Woman’s Medical College and of the thirty-odd alumnae
who entered the clinical lectures. The college scrapbooks gather clippings
from the major Philadelphia and New York dailies, weekly magazines, and
smaller local papers. Eliza Wood-Armitage carefully kept a smaller scrap-
book of clippings. Sarah Hibbard, one of the more eccentric Woman’s Medi-
cal College students, wrote out collections of quotations from press accounts
of the jeering incident in one of her draft “lectures and sermons.” “I will not
give particulars,” she wrote, “I will quote however a few lines from one of
the leading journals upon this subject.” One quote leads to another; soon,
Hibbard has four pages of extracts, a kind of handwritten scrapbook.58 The
jeering incident was an attempt to shame women medical students out of
the first important professional public space they had been allowed to enter.
They countered this exposure by collecting, arranging, and preserving public
accounts in which their harassers had been exposed and shamed; as in the
amphitheater, the gaze of another was much more powerful than one’s own.
The scrapbooks painstakingly compiled by the students of the Woman’s
Medical College construct a kind of portable public space, a transposition of
the abstract relations of public discourse, in which writers address a general
audience, to the domestic form of the album.
The visual economy of the nineteenth-century medical amphitheater is
aligned, in many ways, with that of the nineteenth-century theater, which
was a central location for forming the relations between representations and
spectators. It is perhaps relevant to the jeering incident that the conventions
of theatergoing excluded ladies unescorted by men from the theater. Mary
Ryan’s study of the gender geography of public space records an observation
that, in a Broadway theater, “one-quarter of the house is set aside exclusively
for the use of [prostitutes] in which they nightly and publicly drive their
sickening trade”; her characterization of the theater as a “den of male socia-
bility” tellingly recalls the assumption of male medical students and faculty
that unconstrained exposition would be impossible in the presence of
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women.59 The medical amphitheater may have realized, for some partici-
pants, a fantasy of an entirely male theatrical space, one in which the spectac-
ular body of the patient supports an intense identification between the lec-
turer and the audience.
And nineteenth-century physicians advised their patients about the the-
ater, just as they pronounced on diet, clothing, and ventilation. In his 1850
thesis, “An Essay on the Moral and Physical Education of Females,” Univer-
sity of Pennsylvania medical student Abram Smith compared the Roman
matron at the Colosseum to the modern theatergoer; his account of the the-
ater’s attractions and dangers becomes all too lively:
Wherever you see a theater you will find plenty drinking houses, grogshops, and
whoever chooses to give them a visit will find them filled with our Chesnut St.
mustached dandies with their segar in one hand and a glass of brandy in the
other, as speaking of the gentlemen is getting off my subject. I only mention it
to show the moral influence a theatre exerts within its neighbourhoods. One
great cause which affects the health of our theatre going ladies, is the late hour
to which they are exposed. The piece is generally long. Which occupies them
until eleven or twelve oclock. Whoever that has been at a theatre knows of kind
of persons the audience is composed of. Let the fair “belle” who would not con-
descend to speak to their servants in the kitchen take a look at the “pit and third
tier” and see the company they are in. And if they do not blanch their moral
feelings must be refined indeed.60
Smith, who later in the thesis apologized for writing such a “nauseous” para-
graph,61 here recorded quite accurately the wandering identification of the
spectacle. The lady who goes to the theater comes to resemble the dandy
with his segar and his brandy, the bad company of the cheap seats, and espe-
cially the performer, who throws “her light fantastic legs above her head,
exposing her form to the whole audience.” 62 The mere presence of a woman
at such a spectacle shows her to be without moral feeling; she has made
herself available as an object of the gaze.
And the same D. Hayes Agnew who had resigned from the Pennsylvania
Hospital rather than lecture to women was also an active antitheatrical pam-
phleteer. His memorialist, in fact, connected his “belief that the theatres,
against which he once wrote a vigorous philippic, were on the whole both
a cause and a symptom of moral deterioration in the community” and his
disapproval of “the co-education of the sexes, [and] of the medical education
of women under any circumstances, believing that any possible advantages
to them were far more than counterbalanced by what he thought would be
the inevitable loss of dignity and delicacy resulting from the association of
the sexes under such conditions and from the character of their studies.”
Agnew was willing to suffer for these beliefs: “In accord with the one opinion
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Figure 13. Thomas Eakins’s The Agnew Clinic, unveiled at the University of Pennsylvania on
May 1, 1889, to commemorate Agnew’s retirement (Photograph courtesy of the University of
Pennsylvania School of Medicine)
he denied himself during his whole life the pleasure he would undoubtedly
have derived from seeing the masterpieces of the drama, many of which he
was fond of quoting, enacted on the stage. In accord with the other, he re-
signed a valuable hospital position, and, in spite of strong pressure, refused
many lucrative consultations.” 63
A moral rejection of the theater might seem to be a contradictory position
for a man whose medical lectures were known to “make the boys yell,” who
performed twice a week, for most of his life, in a space known as an amphi-
theater, and who is shown, in Eakins’s painting The Agnew Clinic, in his cus-
tomary (and quite dramatic) attitude, addressing attentive students, while an
assistant finishes surgery (a mastectomy, and therefore at this time a pallia-
tive procedure) on the unconscious woman patient.64 (See figure 13.) It was
not that Agnew disliked the performance or even the theater; he found it
“fascinating in the extreme.” Its very liveliness of representation made it an
effective enticement: “Satan could not arrange a more complete programme
to seduce the souls of men into actual and mental whoredom.” 65 And Ag-
new’s antitheatrical pamphlet deploys the same unstable economy of identi-
fication that made the presence of women physicians at the clinical lecture so
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Forbidden Sights
disturbing. Agnew considered theaters dens of prostitution, hated theatrical

dances in which women were “twirled, and handled,” but objected most of
all to the “distinct personations” of dramatic performance, the fact that vices
were there “faithfully imitated.” For Agnew, since representations of virtue
could never be as exciting as those of vice, the theater must be a display of
compelling and exciting images of evil. Those who saw such characters were
drawn by their very vividness and variety, no matter how the plot condemned
or punished them. For a woman to witness such a performance was to be-
come part of the spectacle: “How dare she meet the vulgar gaze of gaping
spectators, the coarse laugh and boisterous plaudits of pit and dome; and
mingle with the vilest libertines who disgrace God’s footstool.” 66 Agnew’s ob-
jections to women physicians were phrased in quite similar terms. In his
inaugural lecture at the School of Medicine of the University of Pennsylva-
nia, given immediately after he had resigned from the Pennsylvania Hospital,
Agnew argued that while women were generally mentally and physically un-
suited to the demands of medicine, those few who were suited to medical
work were monstrous, at once an illicit spectacle and illicit spectators:
It is within the range of possibility, under modern views, to develop a race of

women, who may yet inaugurate a Platonic republic, where men and women
may wrestle in the same gymnasium, nuda cum nudis; or, like the Greeks, plunge
into the same bath; or maidens, like those of Rome, who could witness unmoved
the fierce encounters of the Coliseum, and after the slaughter was ended, sit
down, in the arena wet with human gore, to enjoy a sumptuous repast.
Agnew chillingly warned that such women would forfeit the protection of
men; if a woman sought to “amputate limbs, make perineal section, or cut
for stone; let her remember there are laws controlling the social structure of
society, the operation of which will disrobe her of all those qualities now the
glory of the sex, and will cast her down in the dust of the earth.” 67 The
woman physician, like the woman at the theater, was both exposed and put
at risk by what she saw.
These antitheatrical warnings model the anxieties that attended women’s
entrance to the clinical amphitheater. That space, that “Holy of Holies,” 68
could easily become a scene of carnival disorder, no better than the vulgar
display of the commercial theater, in which the body was excited, betrayed
into disorganized identification, and subjected to contagion. A woman who
saw, with the eye of science, the spectacle of exposure, disrupted the gender
binary that guaranteed scientific detachment. She transformed the men who
saw her watching into a disorderly mob. These anxieties became more in-
tense, and also more contained, when the spectacle was staged in yet another
privileged space—the dissecting room.
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THE DISSECTING ROOM
If the clinical lecture was a liminal space where the hospital met the medical
college, where patient care met instruction, where students from diverse
institutions gathered, the dissecting room was the heart of an individual
medical school. Each school maintained its own dissection room and hired
a Demonstrator of Anatomy to secure material and supervise students. Al-
though dissection was an optional experience for male medical students, they
were expected to perform autopsies, practice surgical procedures on cadav-
ers, and dissect “parts.” Those who wanted additional instruction could at-
tend such private institutes as the Philadelphia School of Anatomy, directed
by none other than D. Hayes Agnew, which taught 200 to 250 students a
year during the 1850s.69
In some ways, the practice of the dissecting room was not particularly
marked by gender. When Woman’s Medical College student Mary Theodora
McGavran visited the Hahnemann dissecting room in 1899, she remarked,
“A mans dissecting room doesn’t differ materially from a womans—Ours is
a little larger I think.” 70 There is no evidence that women medical students
followed dissection procedures different in any way from those of male med-
ical students, although the atmosphere of the room was probably quite dif-
ferent from that of the men’s schools. And women students told the same
stories of dissection as male medical students: they were frightened or re-
pulsed at first but grew fascinated by what they learned; sometimes they
made jokes about the body they were dissecting or imagined it as reani-
mated. Three accounts of dissection from the 1890s establish the range.
Edith Flower Wheeler remarked that the dissecting room “did not smell like
a rose garden” and that she had to “beat down the aversion to cutting flesh
that had once been living, even as you or I.” But, she declared, it could be
done, and “in time the interest blotted out the shrinking.” 71 Later, practicing
surgery on a corpse, Wheeler indulged in gallows humor: “I did a laparotomy
on a patient today, a dead one. Had lots of fun. Succeeded in poking holes
through everything that I ought not to. If my patient had not been dead to
start with, she would have been deader’n a door nail by the time I got
through.” 72 Anne Walter Fearn, an 1893 graduate of the Woman’s Medical
College, remembered her dissection experiences forty years later: Just be-
fore dawn, as she prepared a corpse for the next day’s demonstration, she
“tugged at the tendon on the arm outstretched on a board. The arm jerked,
clasped itself around my waist, and stayed there.” 73 Unlike male students,
however, women students do not seem to have been prone to sexual humor
in the dissecting room.74 But they did joke about their fears of dissection and
sometimes personified the skeletons they studied. (See figure 14, in which
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Figure 14. Sylvia Hatton (WMC 1899) with “Chimmie Fadden,” her nicknamed skeleton,
1895–96 (Archives and Special Collections on Women in Medicine, MCP Hahnemann
University)
Sylvia Hatton [Woman’s Medical College graduate, 1899] clowns with

“Chimmie Fadden,” her skeleton, and figure 15, in which four members of
the class of 1896 arrange themselves in a column, embraced by the head and
forearms of a skeleton. Both photographs flaunt the medical students’ com-
fort with images of death; both play with the incongruity of the image of
death and the maiden transposed into a professional and scientific setting.
Sylvia Hatton is studying the articulation of her skeleton’s wrist, and the na-
ked, grinning skull in the 1896 photograph is juxtaposed with the new gradu-
ates’ serious faces, caps, and gowns.)
Early in the history of the Woman’s Medical College, the construction of
the dissecting room and the appointment of the Demonstrator were sensi-
tive decisions. The first annual announcement assured readers that “The
Anatomical Rooms will be furnished with every convenience and kept
strictly private. They will be under the supervision of the Professor of Anat-
omy, aided by competent female assistants.” 75 The Demonstrator of Anatomy
213
Figure 15. Top to bottom: Elizabeth Wray-Howell, M.D., Mary Mont-
gomery Marsh, M.D., Grace Shermerhorn, M.D., and Laura Hills, M.D.
(from whose scrapbook this picture was taken), graduates of the Woman’s
Medical College of Pennsylvania, class of 1896 (Archives and Special Col-
lections on Women in Medicine, MCP Hahnemann University)
Forbidden Sights
was, like the clinic assistant, a highly trusted graduate; she was probably the
first woman to work as a professional instructor in an American medical
school. When the demonstrator had some difficulty obtaining “material,” the
faculty passed a resolution that “the Demonstrator in this College has all the
rights and privileges of the most favored Demonstrator in this City and she
is authorized to purchase and prepare subjects for Demonstration and pre-
sent or sell them to the class at her own expense.” 76 (The minutes often
mention the janitor, however, as the person responsible for procuring a
corpse.) And the faculty and corporators agreed that the dissecting room
should be separate from the school and closed to men; in this space, there
would be no untoward mixing of the genders. The act of dissection was to
be carried out in privacy, almost in secrecy; the book of the body would open
itself only in an enclosed space.
In the mid-nineteenth-century medical economy of the visual, dissection
occupied a privileged place. The work was done under an inexorable time
constraint; without refrigeration or reliable preservatives, dissection had to
be done quickly and only in the winter. (Frankenstein is, among other things,
a demonstration of the dangers of summer dissection.) The corpse was held
and propped, sometimes with the tools that would have restrained the living
body for surgery without anesthesia, sometimes with more industrial sup-
ports. Such supports are visible in the background of a student group photo-
graph taken in the Woman’s Medical College anatomy laboratory in 1897.
(See figure 16.) The scene of dissection could become grotesque. Consider,
for example, the following directions for dissection of the (male) perineum,
from Wilson’s System of Human Anatomy:
To dissect the perineum, the subject should be fixed in the position for lithot-
omy, that is, the hands should be bound to the soles of the feet, and the knees
kept apart. An easier plan is the drawing of the feet upwards by means of a cord
passed through a hook in the ceiling. Both of these plans of preparation have for
their object the full exposure of the perineum. And as this is a dissection which
demands some degree of delicacy and nice manipulation, a strong light should
be thrown upon the part. Having fixed the subject, and drawn the scrotum up-
wards by means of string or hook, carry an incision from the base of the scrotum
along the ramus of the pubes and ischium and tuberosity of the ischium, to a
point parallel with the apex of the coccyx; then describe a curve over the coccyx
to the same point on the opposite side, and continue the incision onwards along
the opposite tuberosity, and along the ramus of the ischium and of the pubes, to
the opposite side of the scrotum, where the two extremities may be connected
by a transverse incision. This incision will completely surround the perineum,
following very nearly the outline of its boundaries. Now let the student dissect
off the integument carefully from the whole of the included space, and he will
expose the fatty cellular structure of the common superficial fascia, which ex-
actly resembles the superficial fascia in every other situation. . . .77
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Forbidden Sights
Figure 16. Student group photograph in anatomy laboratory (note supports and apparatus in
the background), class of 1897 (Archives and Special Collections on Women in Medicine, MCP
Hahnemann University)
The spectacle of the exposed corpse is presented to the presumably male

student as a double bind: having secured and exposed his subject and per-
formed what must have seemed to be a castration, the student is to find
nothing unusual in the tissues of the genitals, only superficial fascia that re-
semble those of “every other situation.” The work of dissection performed a
spectacular exposure of the body in order to assure the student that there
was nothing in particular to expose; the student is invited to reframe the
corpse and its genitals with the eye of science and then to proceed below
the superficial.
The copy of Wilson’s System of Human Anatomy from which this quote
was taken belonged to Ann Preston. Preserved as a relic, it is carefully
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Forbidden Sights
marked; Preston drew the indexing letters onto the corresponding structures
in Wilson’s drawings, underlined passages, and kept lists of scientific facts on
the flyleaves—complementary colors, distances of the planets from the sun.
Presumably, Preston moved from the anatomy’s painstaking topographic
prose to the engraved illustrations to the material body in front of her. The
anatomy text offered her a particular mapping of the body, which she sur-
rounded with other systematic reductions of the natural world. It was her
task as a student to transform the corpse before her into an approximation
of the anatomical text and figure, to make a “preparation” of an organ or
system that “demonstrated” its structures and relations. In dissection, the
work of seeing was supported by the work of arranging and constructing; the
opening of the body revealed nature, but the labor of the student rendered
it intelligible. Preston’s copy of Anatomy speaks of the struggle of students
at the early Woman’s Medical College to normalize for themselves the cul-
ture of dissection, to find their place in the visual economy of medicine.
Often, their normalization worked; the act of dissection spoke to intense
desires of women students for a particular experience of the body and could
be articulated with cultural practices, popular in reform circles, of physiolog-
ical investigation. The Woman’s Medical College Alumnae Association me-
morial notice for Ida Richardson, who graduated from the college in 1879,
spoke of her conversion to dissection. Richardson had resisted the whole
idea of a medical career because she hated publicity but had finally decided
that she was divinely called to be a doctor. Her doubts continued through
her first year of medical school, and she decided to test her vocation by be-
ginning to dissect. An older student urged her to “accustom herself to the
room.”
At first she resisted, but finally yielded, and consented to sit by while the others
worked, and read to them from the anatomy in regard to the tissues uncovered
in the dissection. Soon after this she began the work for herself, and instead of
its weaning her from her chosen course, she forgot the unpleasantness in the
marvelous beauty of the hidden tissues of the human frame. Her enthusiasm
over dissection was so great that she aroused all the students around her and
carried them with her, and became the life of the room.78
This is not the “necessary inhumanity” which historian Ruth Richardson has
identified as the dissector’s response to “tasks which would, in normal cir-
cumstances, be taboo or emotionally repugnant,” understandable though
that would be.79 Instead, Ida Richardson seems to have experienced an aes-
thetic conversion, a slowly staged seduction by the beauty of the interior
spaces of the body. Precisely because the dissection room was private, re-
mote from the publicity that she dreaded,80 Richardson could enter its visual
economy by reading aloud, appropriating the voice of the text. Her memori-
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alist uses not the language of scientific conquest but that of bodily care and
appropriation; we read of weaning, of arousal, of life.
Many of the early women physicians had been attracted to dissection from
girlhood; we might recall Hannah Longshore’s dissection of “the bodies of
insects, rodents, and domestic animals . . . as at times convenient they fell
into my hands,” and Mary Putnam Jacobi’s designs on the rat’s heart in the
barn.81 For others, dissection was, as for Richardson, a trial of their vocation.
When Elizabeth Blackwell was preparing for medical study, one of her fellow
teachers gave her a dead cockchafer (a large beetle) “as a first subject for
dissection”:
I accepted the offer, placed the insect in a shell, held it with a hair-pin, and then
tried with my mother-of-pearl handled penknife to cut it open. But the effort to
do this was so repugnant that it was some time before I could compel myself to
make the necessary incision, which revealed only a little yellowish dust inside.82
Striking in this account is Blackwell’s attempt to perform a “scientific” dissec-

tion with the paraphernalia of feminine charm: a shell, a hairpin, a decorative
knife. No wonder she felt queasy. Later, in Philadelphia, Blackwell studied
in a private anatomical school. The teacher
by his thoughtful arrangements enabled me to overcome the natural repulsion

to these studies generally felt at the outset. With a tact and delicacy for which I
have always felt grateful, he gave me as my first lesson in practical anatomy
a demonstration of the human wrist. The beauty of the tendons and exquisite
arrangements of this part of the body struck my artistic sense, and appealed to
the sentiment of reverence with which this anatomical branch of study was ever
afterwards invested in my mind.83
Again, Blackwell’s dissection is organized as a private study, an inquiry into

the subjectivity of the anatomist. She brought the wrist to her room and
worked on it there. She demonstrated the tendons and bones of the corpse’s
wrist, but it was her own hand and wrist that opened them to view. Dissec-
tion disclosed the structure of the body, including the body of the dissector.
If dissection was for Galen an opening of the body “in order to see deeper
or hidden parts,” for nineteenth-century women physicians this act of open-
ing and viewing could become pleasurable.84 In a culture that did not have
x rays or microscopic photographs, not to mention sonograms or MRIs, the
pleasures of dissection could be modeled, at least for reform women, on the
newly acceptable pleasures of reading fiction. If the clinical lecture aroused
the anxieties associated with theatrical performance, dissection, after the
first “horrors” were past, could become as interesting, as absorbing, as novel
reading. The body, since the Enlightenment, had been seen as a “book of
nature”: the illustration in Johann Kulmus’s 1732 collection of anatomical
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Forbidden Sights
plates shows a library, unveiled by a female allegorical figure, where a female

dissector invites us to inspect a female corpse arranged on the revolving table.
(See figure 17.) Both the body and the books are closed, but only for the
moment. This trope was still robust in nineteenth-century medical discourse.
D. Hayes Agnew, anatomist and opponent of the medical education of
women, declared in his 1870 introductory lecture that dissection was “a
charming task” and proclaimed: “The lifeless frame is the greatest of all
books. Turn over its leaves with untiring diligence. You can never know its
contents too well.” 85 As we have seen, dissection was itself guided by the
directions in an anatomy text; a student not lucky enough to have Ida Rich-
ardson reading aloud could keep the anatomy propped before her as a refer-
ence, so that there was an unusually intimate correspondence between the
written word and the materials of the body that students uncovered. (See
figure 18.) That correspondence mediated the labor of dissection; rather
than experiencing it as work, both Richardson and Blackwell (like Long-
shore, or Jacobi in “A Martyr for Science”)86 saw dissection as a practice of
seeing, opening the body to an intent gaze. Paradoxically, dissection at once
dissolved the body and revealed it. Familiar limbs and features gave way
to fascia, everywhere the same, and revealed the bones, heart, and stomach
everyone had experienced in her own body but had never seen before.
The family group, listening to novels about lives like their own, forming
themselves as spectators of the newly elaborated institutions of authorship
and entertainment, themselves immobile and absorbed, had something in
common with these avid women, gathered in a private room, gazing into a
(radically) immobile body which they had in a material sense made to disap-
pear, working out the correspondences between its structures and a text ar-
ranged before them. Both the dissected body and the literary text required
artful arrangement; both displayed the labor of delicate preparation. And,
like the readers of domestic fiction, the woman medical student engaged in
dissection was also an object of moral instruction, finding religious lessons
in the structures she uncovered.87 If the sensibility developed in the reading
of literature was, from the early days of the Republic, an “idiom that special-
izes in inside-outside transferences,” that idiom could structure the work of
dissection, the ultimate realignment of bodily borders.88
The dissected body could be an intensely particular scene of instruction,
both scientific and moral. In 1886, Rachel Bodley, dean of the Woman’s
Medical College of Pennsylvania, received a “singular request” from a
woman with whom she had corresponded on religious matters; the woman
wanted her body to be claimed after death as the property of several Wom-
an’s Medical College professors and to be dissected as a test of her theory
about the continuation of sexual sensation after the ovaries had been re-
moved. The correspondent claimed that a Dr. Mills had published this the-
219
Figure 17. The Human Body and the Library as Sources of Knowledge, illustration for Johann
Adam Kulmus’s Tabulae anatomicae, Amsterdam, 1732 (Photograph courtesy of the History of
Medicine Division, National Library of Medicine, Washington, D.C.)
Figure 18. Woman student from the Woman’s Medical College of the New York Infirmary dis-
secting a leg, illustration for Frank Leslie’s Illustrated Newspaper, April 16, 1870 (Photograph
courtesy of the History of Medicine Division, National Library of Medicine, Washington, D.C.)
Forbidden Sights
ory, although she had never seen the publication.89 She wanted to be dis-
sected so that she could “prove on her body,” to use Ann Preston’s phrase,
“why a consciousness of sensation in the lower sexual organs, remains when
there is no motor sensation passing above the space from which the ovaries
have been removed.” She outlined a theory of a residual nerve connection
in the stump; accordingly, she directed that the nerves should be “traced
back to their roots so that proof may be had that the cure of nymphomania by
oophorectomy is effected by separating some telegraphic connection leading
from the sexual organs to the brain.” If her theory was proved, the correspon-
dent asked that her case history and the results of the investigation be “read
before the students of the Woman’s College” and later published “for the
benefit of science”; she listed two physicians and two lay people who should
be invited to the lecture. But the will was to remain utterly secret until the
woman’s death. An appended note says that no physician “would have a right
to urge this operation upon a patient” and describes her own history as “that
of a woman . . . who was willing to lose her life rather than have it stained
with shame”; she ends by acknowledging that “the peace God gave her [such
as it was] has been dearly bought, but the price is not too much for anyone
who wants to do right.” Much of this deeply felt document is obscure; it
seems that the writer had suffered from something that was diagnosed as
nymphomania and that, although she submitted to an oophorectomy, she
was surprised to still feel sensations from the “lower sexual organs.” Although
she had her own ideas about the cause of these sensations, only dissection
could settle the case, tracing her sensations to their roots. Through dissec-
tion, the intensely private experience that dominated this writer’s life would
become public. Her case would be known; her body displayed; an appropri-
ately selected audience would witness the physical truth of her condition;
and a more anonymous account would enter the scientific record. This dis-
section would do the work that another writer might have undertaken in an
autobiographical novel or memoir: representing to a discerning audience the
intractable truth of an embodied life. What the writer could not know about
herself would be known because of her; the unresolved contradiction of her
final note—at once condemning the operation and enjoining it as not too
much for someone who aspired to do right—would be settled by dissection
and proclaimed in a systematic scientific discourse. Dissection was so much
a practice of reading that, for Bodley’s correspondent, it was also a practice
of writing.
While it was generally less controversial than attendance at mixed clinical
lectures, women’s practice of dissection could also be seen as threatening,
particularly in mixed settings. At the coeducational National College of Med-
icine at the Columbian University in Washington, D.C., tensions between
men and women students came to a crisis in 1892. Zakrzewska’s autobiog-
222
Forbidden Sights
raphy reports that some of the male students “so debased themselves by
offering insult, not only to the women medical students, but also to the help-
less bodies of their fellow beings who had been given to them for scientific
study,” that official action was required.90 The faculty and trustees voted not
to admit any more women students. In The Gilded Age, Ruth Bolton found
herself at night in the dissecting room with the corpse of an African Ameri-
can man who is imagined as objecting to the humiliation of ending a life of
oppression by being dissected by a woman.91 Much worse things could be
imagined: the Boston Medical and Surgical Journal of February 23, 1871,
ran a story under the heading “Outrage at a Woman’s Medical College,”
which was reprinted from the Richmond and Louisville Medical Journal.92 It
told of students at the Cleveland Medical College who had received the body
of a poor woman for postmortem examination and had pledged to give it a
decent burial. An Episcopal minister was secured, and rites were performed,
but “suspicions were aroused” by the lack of a grave in the cemetery:
The coffin was then opened and found to contain billets of wood. The body, the
“lady students” had retained for their delectable entertainment! Apart from the
revolting and repulsive enormities of such a scandalous transaction, and apart,
also, from the abhorrent violations of a sacred pledge, how can any one, in terms
sufficiently excoriating, denounce those who would thus deliberately have per-
formed over a mass of wood, the most sacred and solemn rites known to man?
Such appalling blasphemy is without precedent and beyond description.
The writers seem equally scandalized by the ceremony at the empty grave
and the theft of the body; for them, the case demonstrated that a woman
who left her sphere was soon “lost to every instinct which brings to her sex
its tenderest blessings.” Like the staff of Pennsylvania Hospital, zealously
regulating the cancellation of indelicate lectures, these writers feared that
any change in women’s customary place in the visual economy of medicine
would lead to unnameable transgressions. The vectors of the moralizing
scene of dissection are reversed: the body disappeared, not because it was
opened to science, but because it had been stolen. Dissection involved not
private instruction but a fraudulent public display. Rather than a confirma-
tion of piety, the dissection led to blasphemy. Only the absorption, the inter-
est, the “delectable entertainment,” is the same.
Faced with such intractable discursive energies, women physicians and
their supporters drew upon all their rhetorical resources to justify their pres-
ence both at clinical lectures and in the dissecting room. Sometimes they
argued from consistency, a warhorse of the movement for women’s medical
education: if women were inherently modest, then respect for their modesty
required female doctors. Or consistency could motivate equal treatment: if
male students saw female patients in clinical lectures, then women students
223
Forbidden Sights
should see male patients treated: “These ladies had an absolute right there;
they were admitted by precisely the same authority that admitted the black-
guards; and more than this, it was right that they should accept the privilege
offered them if they wished to do so.” 93 But the argument from consistency
could be complicated by the logic of the separate female sphere. If women’s
modesty required female physicians, then men’s modesty must be protected
from the gaze of women. “The women have their own hospital; why not let
them attend it?” 94 The Woman’s Medical College faculty extended the prin-
ciple of consistency to the patient exposed in the clinical lecture; this argu-
ment was seldom taken up by their supporters:
Into these clinics, women also—often sensitive and shrinking, albeit poor—are
brought as patients to illustrate the lectures, and we maintain that wherever it
is proper to introduce women as patients, there also it is but just and in accor-
dance with the instincts of the truest womanhood for women to appear as physi-
cians and students.95
But of course, this argument could cut two ways: if male medical students
were “coarsened” by viewing women patients, then medical women were
tainted by seeing male patients. And of course there was the modesty of the
male patient, the male medical students, the male lecturer, all of which
found their own advocates.
Against these claims, supporters of women’s medical education advanced
the proposition we first met in Zakrzewska’s autobiography, that “science has
no sex.” Science was proposed as a neutral ground between the genders. The
faculty of the Woman’s Medical College argued:
We maintain, in common with all medical men, that science is impersonal, and
that the high aim of relief to suffering humanity sanctifies all duties; and we
repel, as derogatory to the profession of medicine, the assertion that the physi-
cian who has risen to the level of his high calling need be embarrassed, in treat-
ing general diseases, by the presence of earnest women students.96
Journalists made the same point more floridly:
If all medical students could be endowed with a proper conception of the work
they have in hand they would quickly part with all restricting observances, would
lose their personality in the great search for truth, would be transported to that
ideal sphere where mind holds communion with the Infinite, and where no un-
clean thought is allowed to enter. They would drink in the ultimate aim and
scope of scientific revelation, and be so absorbed in their philanthropic mission
as to pass beyond the trammels of custom, rank, sex, and occasion.97
The sight of the suffering or exposed body of the patient is recuperated

through the rhetoric of romantic benevolence, which transforms earnest im-
224
Forbidden Sights
personality into sublime transcendence. The gaze of science, far from being
detached and neutral, is both erotically united with its object and released
from the social debts of the subject. The visual economy of medicine is re-
imagined as a domain where the gaze of the physician can produce both
knowledge and pleasure, both science and care.
This book has concentrated on the written texts produced by women physi-
cians and their supporters and has investigated how those texts managed
medical care and created medical knowledge. In examining the work of the
clinical lecture and the dissecting room, I extend this analysis to include
other practices by which medicine created knowledge, knowledge that
would eventually find a textual realization, placing these practices in relation
to reading and writing. The performances, spectacles, and representations
that shape those practices show us how women physicians found pleasure
and produced knowledge in the work of medicine.
This book began with the young Marie Zakrzewska calmly spending the
night in the dead house, cured of her weak eyes, taking up her two borrowed
medical books. It ends with images of women entering the amphitheater,
organizing their own dissecting rooms, writing their own books. This is not,
of course, the end of the story; after the Flexner report and the admission of
women to male medical schools in the late 1880s, the women’s schools which
had graduated so many physicians and developed so many teachers quickly
closed. Only in conservative Philadelphia, where women were excluded from
the University of Pennsylvania School of Medicine and the Jefferson Medical
College, did the women’s medical college remain open. In the early decades
of the twentieth century, while women sought higher education in increasing
numbers, the absolute number of women physicians declined.98 Now, as
feminists and science educators search for the reasons that women are un-
derrepresented in the sciences, Zakrzewska’s motto seems quaint, almost
sentimental; for contemporary feminists, science has a sex, and that sex is
male. This book has been an investigation of what it might mean if we were
not to understand science as having a stable sex or if we were to understand
the sex of science as evolving under the pressure of women’s discursive for-
mations. The answer to that question is neither unitary nor universal, since
women physicians took up medical writing in a variety of registers, for a
variety of aims, in a variety of institutional and scientific rhetorics. Some, like
Ann Preston, were virtually anonymous as writers; Preston, however, created
the institutional rhetoric for a women’s medical school. Others, like Hannah
Longshore, wrote very little and withheld any overt statement of the in-
forming purposes of their writing. Longshore’s work, however deeply idio-
syncratic, was also intimately connected with the whole range of political and
religious interests known as reform. Some women physicians intended to
225
Forbidden Sights
write, and wrote, a medicine that was indistinguishable from that written by
males, but even Mary Putnam Jacobi’s writings insisted on the specificity
of female physiological experience and developed ways of incorporating the
words and experiences of women patients into medical writing. Most of the
writing of female physicians, like most contemporary medical writing, was
not undertaken for publication; in their academic papers and in their meticu-
lous hospital records, these physicians patiently constructed quotidian rheto-
rics of scientific care, incorporating the voices of patients, eliding the as-
sumptions that what was male was normal, establishing a certain distance
from the institutions of the profession, assuming without argument the spec-
ificity of female bodily experience and the neutral benignity of their own
impersonal gaze. Nineteenth-century women physicians wrote very different
kinds of medicine, with very different understandings of what it meant to
write science as a woman. Theirs was a sustained performance of gendered
scientific writing, a performance all the more remarkable in that it was often
supported by the belief that science is outside gender. What happened to all
that labor in the language of medicine? Much of it was lost and forgotten;
some of it vanished into the hegemonic registers of medicine; some of it
languishes in archives. But the material recovery of that labor suggests a new
way of thinking about science, of understanding how women appropriated
the pleasures of scientific work, how they made the language of science, if
not their mother tongue, a fluent second language or perhaps a creole. These
stories suggest that science has had more than one gender and hint that gen-
der (at least in scientific writing) need not eternally be binary. While medi-
cine was emerging as a profession, women shaped and changed its dis-
courses, even as they were being excluded and castigated in other medical
registers. For these women, the dead house of medicine was not simply a
place of horror but also, as for Zakrzewska, a scene of festive knowledge,
“freshly painted . . . with the necessary apparatus . . . while the bodies, clad
in white gowns, were ranged on boards along the walls.” 99 May it be so again,
and for us, and soon.
226
Notes
Works Cited
Index
Notes
The following abbreviations are used throughout the notes and the works cited:
ASCWM Archives and Special Collections on Women in Medicine, MCP Hahne-

mann University, Philadelphia, Pa.
CPP Library of the College of Physicians of Philadelphia, Philadelphia, Pa.
CSHN Center for the Study of the History of Nursing, School of Nursing, Uni-
versity of Pennsylvania, Philadelphia, Pa.
FHL Friends Historical Library, Swarthmore College, Swarthmore, Pa.
HLPH Historic Library and Archives Collection, Pennsylvania Hospital, Phila-
delphia, Pa.
JEFF Thomas Jefferson University Archives, Philadelphia, Pa.
MCHS Montgomery County Historical Society, Norristown, Pa.
PA Rare Book and Manuscript Library, University of Pennsylvania, Phila-
delphia, Pa.
QC Quaker Collection, Haverford College Library, Haverford, Pa.
SL Schlesinger Library, Radcliffe College, Cambridge, Mass.
WMC Woman’s Medical College of Pennsylvania, Philadelphia, Pa.
CHAPTER 1. OUT OF THE DEAD HOUSE
1. Agnes Vietor, M.D., F.A.C.S., A Woman’s Quest: The Life of Marie E. Zakrzew-
ska, M.D. (New York: Appleton, 1924), 16, 17. The account of Zakrzewska’s early life
was based on a letter she wrote to Mary L. Booth, originally published in 1860 under
the title, “A Practical Illustration of ‘Woman’s Right to Labor’: or A Letter from Marie
E. Zakrzewska, M.D., late of Berlin, Prussia.”
2. Vietor, Woman’s Quest, 18.
3. Vietor, Woman’s Quest, 140, 142.
4. Vietor, Woman’s Quest, 67.
5. Linda Lehmann Goldstein, “‘Without Compromising in Any Particular’: The
Success of Medical Coeducation in Cleveland, 1850–1856,” Caduceus 10, no. 2 (au-
tumn 1994): 101–15.
6. For a contemporary analysis of women physicians as engaged in masquerade,
229
Notes to Pages 6–10
see Rosemary Pringle, Sex and Medicine: Gender, Power, and Authority in the Medi-
cal Profession (Cambridge: Cambridge University Press, 1998).
7. Judith Butler, Gender Trouble: Feminism and the Subversion of Identity (New
York: Routledge, 1990).
8. For a general introduction to the rich literature of nineteenth-century United
States medical history, see Charles E. Rosenberg, The Care of Strangers: The Rise of
America’s Hospital System (New York: Basic, 1987); John Harley Warner, The Thera-
peutic Perspective: Medical Practice, Knowledge, and Identity in America, 1820–
1885 (Cambridge, Mass.: Harvard University Press, 1986; rpt. Princeton: Princeton
University Press, 1997); and Morris Vogel, The Invention of the Modern Hospital:
Boston, 1870–1930 (Chicago: University of Chicago Press, 1980).
9. Kenneth Ludmerer, Learning to Heal: The Development of American Medical
Education (Baltimore: Johns Hopkins University Press, 1985), 3. For accounts of the
ways in which medical students supplemented these experiences, see Rosenberg,
Care of Strangers, chaps. 7 and 8; and Leo J. O’Hara, An Emerging Profession: Phila-
delphia Doctors, 1860–1900 (New York: Garland, 1989).
10. Gloria Moldow, Women Doctors in Gilded-Age Washington: Race, Gender,
and Professionalization (Urbana: University of Illinois Press, 1987), 37.
11. Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians
in American Medicine (New York: Oxford University Press, 1985), 244–45; Morantz-
Sanchez is the indispensable source for the history of women in medicine. Other
important works include Ruth Abram, Send Us a Lady Physician: Women Doctors in
America, 1815–1920 (New York: Norton, 1985); Judith Walzer Leavitt, ed., Women
and Health Care in America: Historical Readings (Madison: University of Wisconsin
Press, 1984); Thomas Neville Bonner, To the Ends of the Earth: Women’s Search for
Education in Medicine (Cambridge, Mass.: Harvard University Press, 1992); and Lil-
ian R. Furst, ed., Women Healers and Physicians: Climbing a Long Hill (Lexington,
Ky.: University Press of Kentucky, 1997).
12. Morantz-Sanchez, Sympathy and Science, 92.
15. Warner, Therapeutic Perspective, 16–36.
16. Abraham Flexner, Medical Education in the United States and Canada (New
York: Carnegie Foundation for the Advancement of Teaching, 1910).
17. Morantz-Sanchez, Sympathy and Science, 245; Bonner, To the Ends of the
Earth, 149.
18. Ludmerer, Learning to Heal, 248.
20. Londa Schiebinger, The Mind Has No Sex? Women in the Origins of Modern
Science (Cambridge, Mass.: Harvard University Press, 1989); and Londa Schiebinger,
Nature’s Body: Gender in the Making of Early Modern Science (Boston: Beacon,
1993).
21. For an example of criticism that dismantles tacit gender assumptions, see
Emily Martin, “The Egg and the Sperm: How Science Has Constructed a Romance
Based on Stereotypical Male-Female Roles,” Signs: Journal of Women in Culture
and Society 16, no. 3 (1991): 485–501. For a comprehensive account of women’s
230
entry into scientific careers, see Margaret Rossiter: Women Scientists in America:
Struggles and Strategies to 1940 (Baltimore: Johns Hopkins University Press, 1982).
22. Carol Gilligan, In a Different Voice: Psychological Theory and Women’s Devel-
opment (Cambridge, Mass.: Harvard University Press, 1982); Mary Belenky, B. M.
Clinchy, N. R. Goldberger, and J. M. Tarule, Women’s Ways of Knowing: The Devel-
opment of Self, Voice, and Mind (New York: Basic Books, 1986).
23. Evelyn Fox Keller, Reflections on Science and Gender (New Haven, Conn.:
Yale University Press, 1985); and Evelyn Fox Keller, A Feeling for the Organism: The
Life and Work of Barbara McClintock (San Francisco: Freeman, 1983), 197–207.
24. Bruno Latour and Steve Woolgar, Laboratory Life: The Construction of Scien-
tific Facts (Princeton, N.J.: Princeton University Press, 1979); Gillian Beer, Darwin’s
Plots: Evolutionary Narrative in Darwin, George Eliot, and Nineteenth-Century Fic-
tion (London: Routledge, 1983); Steven Shapin and Simon Schaffer, Leviathan and
the Air-Pump: Hobbes, Boyle, and the Experimental Life (Princeton, N.J.: Princeton
University Press, 1985).
25. See Donna Haraway, Primate Visions: Gender, Race, and Nature in the World
of Modern Science (London: Routledge, 1989); Donna Haraway, Simians, Cyborgs,
and Women (London: Routledge, 1989); Donna Haraway, “A Game of Cat’s Cradle:
Science Studies, Feminist Theory, Cultural Studies,” Configurations 2, no. 1 (1993):
59–72, and the essays based on Haraway’s work in Chris Hables Gray, ed., The Cy-
borg Handbook (London: Routledge, 1995).
26. For a brief summary of work in the rhetoric of science, see Susan Wells, Sweet
Reason: Rhetoric and the Discourses of Modernity (Chicago: University of Chicago
Press, 1996), chap. 2; for a useful summary of feminist studies of science, see Evelyn
Fox Keller, “Feminism and Science,” in Feminism and Science, ed. Evelyn Fox Keller
and Helen E. Longino (New York: Oxford University Press), 3–65.
27. See Paul Gross and Norman Leavitt, Higher Superstition: The Academic Left
and Its Quarrel with Science (Baltimore: Johns Hopkins University Press, 1994); and
Andrew Ross, ed., Science Wars (Durham, N.C.: Duke University Press, 1996).
28. The Biology and Gender Study Group (Athena Beldecos, Sarah Bailey, Scott
Gilbert, Karen Hicks, Lori Kenschaft, Nancy Niemczyk, Rebecca Rosenberg, Ste-
phanie Schaertel, and Andrew Wedel), “The Importance of Feminist Critique for
Contemporary Cell Biology,” in Feminism and Science, ed. Nancy Tuana (Blooming-
ton: Indiana University Press, 1989), 172–87.
29. Ann Ruggles Gere, Intimate Practices: Literacy and Cultural Work in U.S.
Women’s Clubs, 1880–1920 (Urbana: University of Illinois Press, 1997); Catherine
Hobbs, ed., Nineteenth-Century Women Learn to Write (Charlottesville: University
of Virginia Press, 1994).
30. Bruno Latour, “Socrates’ and Callicles’ Settlement—or, The Invention of the
Impossible Body Politic,” Configurations 5, no. 2 (spring 1997): 189–240.
31. Charlotte Perkins Gilman, “The Yellow Wall-Paper,” in The Yellow Wall-Paper,
ed. E. Hedges, rev. 2d ed. (Old Westbury, Conn.: Feminist Press, 1996; short story
originally published 1892 in New England Magazine), 9–36.
231
CHAPTER 2. MEDICAL CONVERSATIONS AND MEDICAL HISTORIES
1. John Harley Warner, The Therapeutic Perspective: Medical Practice, Knowl-

edge, and Identity in America, 1820–85 (Princeton, N.J.: Princeton University Press,
1997), 154–55.
2. For a critical account of the patient as “good historian,” see William Frank
Monroe, Warren Lee Holleman, and Marsha Cline Holleman, “Is There a Person in
This Case?” Literature and Medicine 11, no. 1 (spring 1992): 45–63.
3. For an overview of sociolinguistic studies of gender differences, see Sally
McConnell-Ginet, “Language and Gender,” in Linguistics: The Cambridge Survey,
vol. 4: Language: The Socio-cultural Context, ed. Frederick Newmeyer (Cambridge:
Cambridge University Press, 1988), 75–99. For an overview of theories of language
difference, see Camille Roman, Suzanne Juhasz, and Christanne Miller, eds., The
Women and Language Debate (New Brunswick, N.J.: Rutgers University Press,
1994).
4. See, for example, the comprehensive summaries of research in Elliot G. Mish-
ler, Lorna Amarsingham, Stuart Hauser, Ramsay Liem, Samuel Osherson, and Nancy
Wexler, Social Contexts of Health, Illness, and Patient Care (Cambridge: Cambridge
University Press, 1981), 104–41. For representative specific studies, see Howard
Waitzkin, The Politics of Medical Encounters: How Patients and Doctors Deal with
Social Problems (New Haven, Conn.: Yale University Press, 1991); Ronald Chenail,
ed., Medical Discourse and Systemic Frames of Comprehension, vol. 42 in Advances
in Discourse Processes (Norwood, N.J.: Ablex, 1991); Alexandra Dundas Todd and
Sue Fisher, eds., The Social Organization of Doctor-Patient Communication, 2d ed.
(Norwood, N.J.: Ablex, 1993; originally published, Washington, D.C.: Center for Ap-
plied Linguistics, 1983); Jay Katz, The Silent World of Doctor and Patient (New York:
Free Press, 1984); Elliot G. Mishler, The Discourse of Medicine: Dialectics of the
Medical Interview (Norwood, N.J.: Ablex, 1984); Kathy Davis, “Paternalism under
the Microscope,” in Gender and Discourse: The Power of Talk, ed. Alexandra Dundas
Todd (Norwood, N.J.: Ablex, 1988), 19–54; Candace West, Routine Complications:
Troubles with Talk between Doctors and Patients (Bloomington: Indiana University
Press, 1984).
5. Talcott Parsons, The Social System (Glencoe, Ill.: Free Press, 1951).
6. Charles E. Rosenberg, The Care of Strangers: The Rise of America’s Hospital
System (New York: Basic Books, 1987), 47–68.
7. Pauline Poole Foster, Anne Preston, M.D. (1813–1872): A Biography: The
Struggle to Obtain Training and Acceptance for Women Physicians in Mid-
Nineteenth Century America, Ph.D. dissertation, University of Pennsylvania (Ann
Arbor: University Microfilms, 1984).
8. For the structure of the medical interview, see Waitzkin, Politics of Medical
Encounters, 25–35; and Mishler, Discourse of Medicine, chaps. 3–5. For the rela-
tionship between spoken medical encounters and their written representations,
see Aaron V. Cicourel, “Text and Discourse,” Annual Review of Anthropology 14
(1985): 159–85.
9. Waitzkin, Politics of Medical Encounters, 32.
10. See the special issue of Literature and Medicine 11, no. 1 (spring 1992), on
232
the genre of the case history, especially Julia Epstein, “Historiography, Diagnosis,
and Poetics,” 23–44; and Rita Charon, “To Build a Case: Medical Histories as Tradi-
tions in Conflict,” 115–32. The fullest account of the importance of narrative in physi-
cians’ accounts is Kathryn Montgomery Hunter’s Doctors’ Stories: The Narrative
Structure of Medical Knowledge (Princeton, N.J.: Princeton University Press, 1991).
My account of the structure of the medical interview is drawn from Mishler’s exten-
sive empirical study; it necessarily flattens the varied contours of individual practices.
11. Worthington Hooker, Physician and Patient; or, a Practical View of the Mutual
Duties, Relations, and Interests of the Medical Profession and the Community (New
York: Arno Press, 1972; original publication, 1849), 443.
12. David Silverman, “Policing the Lying Patient: Surveillance and Self-
Regulation in Consultations with Adolescent Diabetics,” in The Social Organization
of Doctor-Patient Communication, ed. Alexandra Dundas Todd and Sue Fisher, 2d
ed. (Norwood, N.J.: Ablex, 1993), 213–43.
13. Hooker, Physician and Patient, 443.
14. Woman’s Medical College, “First Annual Announcement” (Philadelphia:
Clarkson and Scattergood, 1850), 4.
15. Edwin Fussell, “Valedictory Address to the Graduating Class of the Female
Medical College of Pennsylvania at the Tenth Annual Commencement, March 13,
1861,” 7, MCP Collection, ASCWM.
16. Louisa May Alcott, Hospital Sketches, in Alternative Alcott, ed. E. Showalter
(New Brunswick, N.J.: Rutgers University Press, 1988; original publication, 1863), 39.
17. Charles Meigs, Woman; Her Diseases and Remedies (Philadelphia: Lea and
Blanchard, 1851), 282–83.
18. Pierre Choderlos de Laclos, Les Liaisons dangereuses (Paris: Garnier-
Flammarion, 1964), 322.
19. Meigs, Woman, 155–77.
20. Meigs, Woman, 155.
27. Ronald J. Chenail, in Medical Discourse and Systemic Frames of Comprehen-
sion, discusses how the parents of children whose heart murmurs were being diag-
nosed understood their doctors’ evaluations of their condition. Previous studies had
shown that the consequences of parents’ understanding their children to be diseased
were, in many ways, indistinguishable from the consequences of disease itself (A. B.
Bergman and S. J. Stamm, “The Morbidity of Cardiac Nondisease in School Chil-
dren,” New England Journal of Medicine 276 [1967]: 1008–13).
28. Dr. W. Fulton, Case and lecture notes by Dr. W. Fulton, 1866, bound hand-
written notes on clinical cases of Prof. Ellerslie Wallace and Prof. Jacob Da Costa,
Archives MM-207, Thomas Jefferson University Archives. A letter by Joseph Bome-
man, of Bradford Book Company, included in the Fulton files, identifies him as a
physician “who attended Jefferson Medical College after completing his service in
233
the Army during the Civil War” (Feb. 27, 1936; letter contained in Fulton’s case and
lecture notes).
29. Fulton, Case and lecture notes by Dr. W. Fulton, Nov. 1 and 8, 1866.
30. Medical and Surgical Journal (Philadelphia), “Women Are Dirty Creatures,
Anyhow!” 50, no. 1422 (May 31, 1884): 4.
31. S. E. McCully, “Masturbation in the Female,” American Journal of Obstetrics
16, no. 8 (Aug. 1883): 844–45.
32. Lister’s letter, from the Archives of the Edinburgh Royal Infirmary, is quoted
in Shirley Roberts, Sophia Jex-Blake: A Woman Pioneer in Nineteenth Century Medi-
cal Reform (London: Routledge, 1993), 133. Bell’s letter was dated October 30, 1872;
no date is given for Lister’s.
33. Elizabeth Blackwell, Pioneer Work in Opening the Medical Profession to
Women (New York: Schocken, 1977; original publication, 1895), 193.
34. Fulton, Case and lecture notes by Dr. W. Fulton, Dec. 21, 1866.
35. Nancy Theriot, “Women’s Voices in Nineteenth-Century Medical Discourse:
A Step toward Deconstructing Science,” in Gender and Scientific Authority, ed. Bar-
bara Laslett, Sally Gregory Kohlstedt, Helen Longino, and Evelynn Hammonds
(Chicago: University of Chicago Press, 1996), 124–54.
37. See Charles Rosenberg, “The Therapeutic Revolution: Medicine, Meaning,
and Social Change in Nineteenth Century America,” in The Therapeutic Revolution:
Essays in the Social History of American Medicine, ed. Morris J. Vogel and Charles
E. Rosenberg (Philadelphia: University of Pennsylvania Press, 1979); and Warner,
Therapeutic Perspective.
38. Harriot Kezia Hunt, Glances and Glimpses; or, Fifty Years Social, Including
Twenty Years Professional Life (Boston: Jewett, 1856); Rachel Gleason, Talks to My
Patients: Hints on Getting Well and Keeping Well, new ed. enlarged with the addition
of nineteen “Letters to Ladies” on health, education, society, etc. (New York: Hol-
brook, 1895). For an account of the association between women physicians and
empathic treatment, see Regina Markell Morantz-Sanchez, “The Gendering of
Empathic Expertise: How Women Physicians Became More Empathic Than Men,”
in The Empathic Practitioner: Empathy, Gender, and Medicine, ed. Ellen Singer
More and Maureen Milligan (New Brunswick, N.J.: Rutgers University Press,
1994), 40–58.
39. Anna Mott was the author of The Ladies’ Medical Oracle; or, Mrs. Mott’s Ad-
vice to Young Females, Wives, and Mothers, Being a Non-Medical commentary on
the cause, prevention, and cure of the diseases of the female frame, together with an
explanation of her system of European vegetable medicine for the cure of diseases,
and the patent medicated champoo baths; to which is added, an explanation of the
gift, and an exposition of the numerous fabricated reports, “a weak invention of the
enemy” (Boston: self-published, 1834). A handwritten note on the flyleaf of the copy
owned by the ASCWM directs readers to buy these medicines from the Misses Hunt,
Female Doctors.
40. WMC, Faculty Minutes, Jan. 26, 1853, MCP Collection, ASCWM.
41. Hunt, Glances and Glimpses, 156; see also 139, 158, 251.
42. Hunt, Glances and Glimpses, 151.
234

45. See Ann Braude, Radical Spirits: Spiritualism and Women’s Rights in Nine-
teenth Century America (Boston: Beacon, 1989).
46. WMC, “Third Annual Announcement, of the Female Medical College of
Pennsylvania for the Session of 1852–53, Situated in Philadelphia,” 4, MCP Collec-
tion, ASCWM.
47. Dr. Elizabeth C. Keller, “A Case of Laparotomy,” in WMC, Alumnae Associa-
tion, Proceedings of the Twelfth Annual Meeting of the Alumnae Association of the
Woman’s Medical College of Pennsylvania, Mar. 18, 1887 (Philadelphia: Rodgers
Printing Co., 1887), 61–63, MCP Collection, ASCWM.
48. Keller, “Case of Laparotomy,” 61.
51. For a similar enthusiasm for surgery, see the account of Mary Dixon Jones’s
use of Tait’s operation to remove the ovaries and Fallopian tubes, in Regina Morantz-
Sanchez, “Making It in a Man’s World: The Late-Nineteenth-Century Surgical Ca-
reer of Mary Amanda Dixon Jones,” Bulletin of the History of Medicine 69 (1995):
542–68. I am grateful to Prof. Morantz-Sanchez for sharing in draft her biography
of Dixon Jones, Conduct Unbecoming a Woman: Medicine on Trial in Turn-of-the-
Century Brooklyn (New York: Oxford University Press, 1999).
54. But see the use of orgasm in S. E. McCully’s letter, “Masturbation in the Fe-
male”: “In some women, so intense is the pleasure of an orgasm proper that it has
been described to me as almost painful” (845).
55. Blackwell, Pioneer Work, 30.
56. Maria Minnis, “Disquisition on Medical Jurisprudence” Respectfully Submit-
ted to the Faculty of the Female Medical College of Pennsylvania as an Inaugural
Thesis for the Degree of the Doctorate in Medicine, by Maria Minnis of Phelps,
New York, Period of study, four years, Preceptors, Caleb Bannister, M.D., and G. F.
Horton. Philadelphia, January 10th, 1853, ASCWM. Minnis writes about means of
identifying criminal abortions but also laments that the lack of physician’s privilege
violates the sacred confidence between physician and patient. See also Sarah Hall,
“A Thesis on the Physical and Moral Effects of Abortion,” Presented to the Faculty
of Woman’s Medical College of Pennsylvania by Sarah C. Hall, Philadelphia Session
of 1869–70, ASCWM. Hall states that the only safe course for the physician was “to
be deaf to all entreaties of this nature, from whatever source, since no finite being
can foretell what modifying influences may be brought to bear upon the most inauspi-
cious birth, it is the very acme of impious assumption to thus deliberately try to thwart
Laws that are unchangeable” (15–16).
(Note: In nineteenth-century thesis titles throughout the volume, I have repro-
duced the orthography of the title page as closely as possible, adding quotation marks
to designate the main title.)
57. Gleason, Talks to My Patients, 160.
235

60. Todd and Fisher, Social Organization of Doctor-Patient Communication;
Mishler, Discourse of Medicine; and Waitzkin, Politics of Medical Encounters.
61. Candace West, “‘Ask Me No Questions . . .’: An Analysis of Queries and Re-
plies in Physician-Patient Dialogues,” in The Social Organization of Doctor-Patient
Communication, ed. Alexandra Dundas Todd and Sue Fisher, 2d ed. (Norwood:
Ablex, 1993), 127–60.
62. Mishler, Discourse of Medicine, 85.
63. M. Balint, The Doctor, His Patient and the Illness (New York: International
University Press, 1957).
64. For a striking instance of a plausible fantasy, see G. Raimbault, O. Cachin, J.
Limal, C. Eliacheff, and R. Rapaport, “Aspects of Communication between Patients
and Doctors: An Analysis of the Discourse in Medical Interviews,” Pediatrics 55
(1975): 401–5, in which a patient diagnosed with Taylor’s syndrome interprets the
physician’s explanation of a missing chromosome as meaning that she is only her fa-
ther’s daughter and has no genetic inheritance from her mother.
65. Michel Foucault, Discipline and Punish: The Birth of the Prison, trans. Alan
Sheridan (New York: Vintage, 1979).
66. Zakrzewska writes:
From the very beginning, I had instituted record books in which the name, age, residence,
occupation, diagnosis and treatment of every individual case were written—of those who
were in the hospital, those who came to the dispensary clinics, and those who were at-
tended at their homes.
These books revealed to the visitors our activity, and they were admired also by our
professional brethren. No such records then existed in their dispensaries but were intro-
duced after our example, primitive as it was in those years.
Agnes C. Vietor, ed., A Woman’s Quest: The Life of Marie Zakrzewska, M.D. (New
York: Appleton, 1924), 234.
67. John W. H. Reber, Surgical Clinic Notebook, 1866, Jefferson Medical College,
Philadelphia, Oct. 14, 1865, MM-25, Thomas Jefferson University Archives. Here
and in other transcriptions, empty square brackets indicate illegible words. All pa-
tient names, when given in the original, have been disguised.
68. Jefferson Medical College, Notebook of Clinical Cases, anonymous medical
student, Oct.–Dec. 1853, quotation from entry for October 6, MM-289, Thomas Jef-
ferson University Archives.
69. Jefferson Medical College, Notebook of Clinical Cases, anonymous medical
student, Oct. 1853.
70. See Waitzkin, Politics of Medical Encounters, chap. 8, for material on the regu-
lation of drugs and alcohol in the doctor-patient conversation; it is also significant
that many of the interactions that Waitzkin found “nonproblematic” were trauma
cases (240–48).
71. Jefferson Medical College, Clinical Notes (probably of the general dispen-
sary), 1866–69, UA-JMC 014, Thomas Jefferson University Archives.
72. Waitzkin, Politics of Medical Encounters, 30.
236
73. Reber, Surgical Clinic Notebook, Oct. 14, 1865.

74. Kersey Thomas, Notebook, “Female Medical College of Pennsylvania, N 229
Arch Street, Philadelphia,” 1854–55, ASCWM. Thomas was a professor at the Wom-
an’s Medical College of Pennsylvania. The book includes accounts of 176 cases
treated in 1854 and 1855, including 23 men, 135 women, 15 children, and 3 who
could not be determined.
75. Thomas, Notebook, patient #2.
78. See, for example, Jefferson Medical College, Notebook of Clinical Cases,
Oct.–Dec. 1853; Eli Carithers, Notebook of Clinical Cases, Jefferson Medical Col-
lege, 1849–50, MM-014; J. Francis Dunlap, Notebook of Clinical Cases, Jefferson
Medical College, 1873–77, MM-029; Reber, Surgical Clinic Notebook; Fulton, Case
and lecture notes by Dr. W. Fulton, 1866; and Jefferson Medical College, Clinical
Notes, probably of the general dispensary; all from JEFF. The closest approximation
to a criticism of medical practice in any of these notebooks occurs in the Jefferson
Medical College, Notebook of Clinical Cases, 1853; the student records, in his notes
for the November 12, 1854, clinic, Dr. Norris’s story of an unnamed doctor who diag-
nosed a fracture as a luxation and crippled a patient; the student remarks, “May the
God of Mercies ever direct me and keep me from taking a fracture for a luxation.”
79. Students were instructed to follow such a form in taking histories. See Charles
Meigs’s demonstration history in Woman, where he directs students to “gather up
the whole history of the case” in a series of fourteen questions, after which the doc-
tor concludes:
“You must let me examine the case; I can’t tell what it is except you allow that.”
“Well, I suppose if I must I must. But don’t hurt me.”
“Not in the least, not at all.” (p. 243)
80. See Epstein, “Historiography, Diagnosis, and Poetics”; Charon, “To Build a
Case”; and Ellen Barton, “Literacy in (Inter)Action,” College English 59, no. 4 (Apr.
1997): 408–37.
81. Warner, Therapeutic Perspective.
82. For a collaborative analysis and critique of problem-oriented notes, see Su-
zanne Poirer, Lorie Rosenblum, Lioness Ayre, Daniel Brauner, Barbara Sharf, and
Ann Folwell Stanford, “Charting the Chart—an Exercise in Interpretation(s),” Liter-
ature and Medicine 11, no. 1 (spring 1992): 1–22.
83. These cases and the longer histories that follow are included in a small collec-
tion of 1868 patient records (Woman’s Hospital of Pennsylvania, Patient Records,
1868–76, Center for the Study of the History of Nursing, School of Nursing, Univer-
sity of Pennsylvania); the handwriting in these short cases is very similar to Emeline
Horton Cleveland’s.
84. These records therefore demonstrate simultaneously specific and prolonged
attention to the patient’s description of her illness and a willingness to deploy the full
range of available numerical measurements of bodily functions, a combination that
John Harley Warner’s survey of hospital histories suggests was rare (Therapeutic Per-
spective, 90–92, 107).
237
85. Woman’s Hospital of Pennsylvania, Patient Records, Case 2071, Sept. 22,
1875.
86. Warner, Therapeutic Perspectives, 159.
87. Woman’s Hospital of Pennsylvania, Patient Records, Case 2213, Apr. 20, 1876.
88. David H. Flood and Rhonda Soricelli, “Development of the Physician’s Nar-
rative Voice in the Medical Case History,” Literature and Medicine 11, no. 1 (spring
1992): 64–83, 70.
89. Woman’s Hospital of Pennsylvania, Patient Records, Case 2315, July 29, 1876.
90. Regina Markell Morantz and Sue Zschoche, “Professionalism, Feminism,
and Gender Roles: A Comparative Study of Nineteenth-Century Medical Therapeu-
tics,” Journal of American History 67 (Dec. 1980): 568–88.
91. Rebecca Cole, “First Meeting of the Women’s Missionary Society of Philadel-
phia,” Woman’s Era 3, no. 4 (Oct./Nov. 1896): 4–5.
92. Gloria Moldow, Women Doctors in Gilded-Age Washington: Race, Gender,
and Professionalization (Urbana: University of Illinois Press, 1987), 130.
93. Blackwell, Pioneer Work, 227–28.
94. Margaret Jerrido, “Rebecca Cole,” typed manuscript, undated, Black Women
Physicians Project, Rebecca Cole file, ASCWM.
95. M. J. Scarlett, “Valedictory Address of Prof. M. J. Scarlett, before the Gradu-
ating Class of the Female Medical College of Pennsylvania, March 16, 1867,” 6–7,
Additional Holdings, Publications, MCP Collection, ASCWM.
96. Black Women Physicians Project, Rebecca Lee [Crumpler] file, transcription
of Faculty Notes for Feb. 25, 1864, ASCWM.
97. Charles Epps, M.D., Davis Johnson, Ph.D., Audrey Vaughan, M.S., “Black
Medical Pioneers: African-American ‘Firsts’ in Academic and Organized Medicine,”
Journal of the National Medical Association 85, nos. 8, 9, 10 (Aug. and Sept. 1993):
629–44, 703–20. See also the local historical research by Ann Rollins, described in the
Boston University University News 2 (summer 1995), 60 (located in Black Women
Physician’s Project, Rebecca Lee [Crumpler] file, [clipping], ASCWM).
98. Rebecca Crumpler, M.D., A Book of Medical Discourses in Two Parts (Bos-
ton: Cashman, Keating & Co., Printers, 1883).
99. Crumpler, Medical Discourses, 3–4.
100. Crumpler’s Medical Discourses references are as follows: doctors’ attendance
for poor women (14), customs of old-fashioned people (28), children caring for
younger siblings (29, 38, 89), hungry children (39), children who failed to thrive (62),
treating cholera (68), and the seamstress (131).
101. Crumpler, Medical Discourses, 119, 16.
102. Crumpler, Medical Discourses, 26.
106. For patient fantasies, see the images of women doctors in novels by
nineteenth-century women, including Elizabeth Stuart Phelps, Doctor Zay (New
York: Feminist Press, 1987; original publication, 1882); Sarah Orne Jewett, A Coun-
try Doctor (Boston: Houghton Mifflin, 1884; reprinted, New York: Penguin, 1986);
and Annie Nathan Meyer, Helen Brent, M.D.: A Social Study (New York: Cassell
238
Publishing, 1892); as well as the discussion of these novels and others in Lilian Furst,
“Halfway up the Hill: Doctresses in Late Nineteenth-Century American Fiction,” in
Lilian Furst, ed., Women Healers and Physicians: Climbing a Long Hill (Lexington:
University Press of Kentucky, 1997), 221–38. There is reason to read these texts as
representations of the patient’s desire; in a letter to S. Weir Mitchell, Elizabeth Stuart
Phelps wrote that she had written Doctor Zay as a “professional invalid . . . in good
and regular standing” and that she “tried to draw a Doctor by reflection, or by reflex
action, the result is, at least, I hope, a patient” (Elizabeth Stuart Phelps, correspon-
dence with S. Weir Mitchell, Jan. 25, 1884, Mitchell files, Library of the College of
Physicians of Philadelphia).
CHAPTER 3. INVISIBLE WRITING I: ANN PRESTON

INVENTS AN INSTITUTION
1. Ann Preston, letter to Hannah Monaghan Darlington, May 26, 1833, MCP
Deans Files, Preston Papers, ASCWM.
2. For details of Ann Preston’s early life, see the exhaustive and invaluable Pau-
line Poole Foster, Ann Preston, M.D. (1813–1872): A Biography: The Struggle to
Obtain Training and Acceptance for Women Physicians in Mid-Nineteenth Century
America, Ph.D. dissertation, University of Pennsylvania (Ann Arbor: University Mi-
crofilms, 1984).
3. Ann Preston, Cousin Ann’s Stories for Children (Philadelphia: McKim, 1849).
4. Foster, Ann Preston, 89, 92, 98.
5. Ann Preston, letter to Lavinia Passmore, Oct. 8, 1843, Letter Collection, Ches-
ter County Historical Society, West Chester, Pa.
6. Eliza Judson, “Address in Memory of Ann Preston, M.D., Delivered by Re-
quest of the Corporators and Faculty of the Woman’s Medical College of Pennsylva-
nia,” Mar. 11, 1873, 14, MCP Deans Files, ASCWM.
7. Ann Preston, letter to Hannah Monaghan Darlington, Jan. 4, 1851, WMC,
Deceased Alumnae Files, Preston Papers, ASCWM.
8. Sarah Mapps Douglass, letters to Hannah White Richardson (a member of the
Board of Lady Corporators), 1850–82, RG5/187: Richardson Family Papers, ser. 4,
Friends Historical Library of Swarthmore College.
9. Anna L. Wharton, letter to her husband, Joseph Wharton, Mar. 12, 1856, RG5/
162: Joseph Wharton Papers, ser. 4.2, Friends Historical Library of Swarthmore
College.
10. See Harold J. Abrahams, Extinct Medical Schools of Nineteenth-Century Phil-
adelphia (Philadelphia: University of Pennsylvania Press, 1966), 213.
11. Ann Preston, “Women as Physicians,” [1875], 7, CSHN. This document was
originally published (with the same title) as a letter to the Medical and Surgical Re-
porter (Philadelphia) 16, no. 18 (May 4, 1867): 391–94. The document now held at
the CSHN was reprinted by the Woman’s Medical College of Pennsylvania; no date
or printer’s address are given, but a postscript refers to an upcoming series of lectures
in the spring of 1875, which is the year to which Foster dates the document. Quota-
tions in this chapter are from the WMC reprint.
239
Notes to Page 61
12. Judith Butler, Bodies That Matter: On the Discursive Limits of “Sex” (New
York: Routledge, 1993), 127.
13. Ann Preston, T. Morris Perot, Joseph Jeanes, and Emeline Cleveland, letter
to Pennsylvania State Medical Society, June 8, 1866, reprinted in Clara Marshall, The
Woman’s Medical College, an Historical Outline (Philadelphia: Lea and Blanchard,
1898), 40–41; Ann Preston and Emeline Cleveland, “Statement of the Woman’s Med-
ical College of Pennsylvania,” in Marshall, Woman’s Medical College, 24–27. The
jeering incident will be discussed further in the final chapter of this book.
14. WMC, Faculty Minutes, 1850–64, MCP Collection, ASCWM. Regarding the
memorial resolutions, see minutes for Dec. 29, 1854; on revising the bylaws, see
minutes for Jan. 2, 1855, and also for Feb. 7, 1863; on writing the college history, see
Jan. 5, 1855.
15. The announcements we can be certain Preston helped to write, on the basis
of the evidence in the faculty minutes, are: WMC, “Fourth Annual Announcement
of the Female Medical College of Pennsylvania . . . for the Session 1853–54,” MCP
Collection, ASCWM (see Faculty Minutes I, May 12, 1853); WMC, “Sixth Annual
Announcement of the Female Medical College of Pennsylvania . . . for the Session
of 1855–56,” MCP Collection, ASCWM (see Faculty Minutes I, Feb. 12, Mar. 1, and
Mar. 2, 1855); WMC, “Tenth Annual Announcement of the Female Medical College
of Pennsylvania . . . for the Session of 1859–60,” MCP Collection, ASCWM (see Fac-
ulty Minutes I, Dec. 27, 1858); WMC, “Fourteenth Annual Announcement of the
Female Medical College of Pennsylvania . . . for the Session of 1863–64” (bound
with “Valedictory Address to the Graduating Class of the Female Medical College
of Pennsylvania at the Eleventh Annual Commencement, March 14, 1863, by Eme-
line H. Cleveland, M.D.”), MCP Collection, ASCWM (the announcement is very
short; see Faculty Minutes I, Feb. 7, 1863).
There is a gap in the faculty minutes from 1864 until after Preston’s death; Foster
assigns the seventeenth to the twenty-third annual announcement to her, since they
were published during her deanship and are mentioned in Judson’s memorial ad-
dress: WMC, “Seventeenth Annual Announcement of the Female Medical Col-
lege . . . for the Session of 1866–67,” MCP Collection, ASCWM; WMC, “Eighteenth
Annual Announcement of the Woman’s Medical College of Pennsylvania . . . for
the Session of 1867–68,” MCP Collection, ASCWM; WMC, “Nineteenth Annual An-
nouncement of the Woman’s Medical College of Pennsylvania . . . for the Session of
1868–69,” MCP Collection, ASCWM; WMC, “Twentieth Annual Announcement of
the Woman’s Medical College of Pennsylvania . . . for the Session of 1869–70,” MCP
Collection, ASCWM; WMC, “Twenty-first Annual Announcement of the Woman’s
Medical College of Pennsylvania . . . for the Session of 1870–71,” MCP Collection,
ASCWM; Woman’s Medical College of Pennsylvania, “Twenty-second Annual An-
nouncement of the Woman’s Medical College of Pennsylvania . . . for the Session of
1871–72,” MCP Collection, ASCWM; WMC, “Twenty-third Annual Announcement
of the Woman’s Medical College of Pennsylvania . . . for the Session of 1872–73,”
MCP Collection, ASCWM.
16. Ann Preston gave a number of introductory and valedictory lectures; ac-
cording to the custom of all medical schools, after the lecture, students (or some
other group within the college) requested that she supply a copy for publication,
240
and the lecture was printed. All these lectures show Ann Preston as their author:
“Introductory Lecture to the Course of Instruction in the Female Medical College
of Pennsylvania for the Session 1855–56,” by Ann Preston, M.D., Professor of Physi-
ology, MCP Deans Files, Preston Papers, ASCWM; “Valedictory Address to the
Graduating Class of the Female Medical College of Pennsylvania for the Session of
1857–58,” by Ann Preston, M.D., Professor of Physiology and Hygiene, MCP Deans
Files, Preston Papers, ASCWM; “Introductory Lecture to the Class of the Female
Medical College of Pennsylvania, Delivered at the Opening of the Tenth Annual
Session, Oct. 19, 1859,” by Ann Preston, M.D., Professor of Physiology and Hygiene,
CSHN; “Valedictory Address to the Graduating Class of the Female Medical College
of Pennsylvania at the Twelfth Annual Commencement, March 16, 1864,” by Ann
Preston, M.D., Professor of Physiology and Hygiene, with Announcement of the Fif-
teenth Annual Session, MCP Deans Files, Preston Papers, ASCWM; “Valedictory
Address to the Graduating Class of the Woman’s Medical College of Pennsylvania at
the Eighteenth Annual Commencement, March 12th, 1870,” by Ann Preston, M.D.,
Professor of Physiology and Hygiene, CSHN.
17. Ann Preston, “Nursing the Sick and the Training of Nurses,” an Address Deliv-
ered at the Request of the Board of Managers of the Woman’s Hospital, at Philadel-
phia, by Ann Preston, M.D., 1863, CSHN; Ann Preston, “Women as Physicians.”
18. Eliza Judson, in her “Address in Memory of Ann Preston, M.D.,” Delivered
by Request of the Corporators and Faculty of the Woman’s Medical College of Penn-
sylvania, Mar. 11, 1873 (MCP Deans Files, ASCWM), speaks of Preston’s journal and
quotes from it. Gulielma Fell Alsop, in her History of the Woman’s Medical College,
Philadelphia, Pennsylvania (1850–1950) (Philadelphia: Lippincott, 1950), refers to
the journal as something she has in hand. However, Pauline Poole Foster, in re-
searching her dissertation on Preston, was not able to locate the journal; nor have
successive archivists at the ASCWM.
19. Mary Mumford, “Remarks at the Woman’s Medical College Golden Jubilee,”
1900, MCP Collection, ASCWM.
20. Mary P. Ryan, Women in Public: Between Banners and Ballots (Baltimore:
Johns Hopkins University Press, 1990).
21. Preston, “Introductory Lecture . . . 1855–56,” 2.
23. Preston, “Valedictory Address . . . 1857–58,” 8.
24. Preston, “Valedictory Address . . . 1864,” 4.
25. Margaret Hope Bacon, Mothers of Feminism: The Story of Quaker Women in
America (New York: Harper and Row, 1986).
26. Lucretia Coffin Mott, Discourse on Woman, Delivered at the Assembly Build-
ings, December 17, 1849 (Philadelphia: T. B. Peterson, 1850); reprinted in Karlyn
Kohrs Campbell, Man Cannot Speak for Her, vol. 2: Key Texts of the Early Feminists
(New York: Praeger, 1989). See also Campbell’s analysis of the speech in Man Cannot
Speak for Her, vol. 1: A Critical Study of Early Feminist Rhetoric (New York: Praeger,
1989), 37–48.
28. Charles Meigs, Woman; Her Diseases and Remedies (Philadelphia: Lea and
Blanchard, 1851), 27.
241

30. Cambell, Man Cannot Speak for Her, vol. 1, 105–21.
32. Preston, “Introductory Lecture . . . 1855–56,” 9–10.
34. John Harley Warner, The Therapeutic Perspective: Medical Practice, Knowl-
edge, and Identity in America, 1820–1885 (Princeton, N.J.: Princeton University
Press, 1997), 75–77.
36. Preston, “Valedictory Address . . . 1857–58,” 11.
38. Preston, letter to Lavinia Passmore, Oct. 8, 1843.
39. The 1870 valedictory address, which would have been written almost immedi-
ately after the jeering incident, is somewhat different in organization and tone. It is
realistically sober in its opening promises: “We can none of us map out the exact
road before you, nor foresee the changes and trials which await you; but there are
unchanging principles of action which can guide safely through all vicissitudes, and
these we trust you will make your own” (Preston, “Valedictory Address . . . 1870,” 1).
The speech is organized as a plea for truth, for the progress of medicine, for a moral
therapy.
40. WMC, Faculty Minutes, Nov. 15, 1859.
41. Campbell, Man Cannot Speak for Her, vol. 1, 11.
42. Marjorie Garber, Vested Interests: Cross-Dressing and Cultural Anxiety (New
York: Harper, 1992), 234.
43. See WMC, “Fourth Annual Announcement of the Female Medical College
of Pennsylvania.”
44. WMC, Faculty Minutes, Mar. 1 and Mar. 2, 1855.
45. WMC, “Sixth Annual Announcement,” 2.
46. WMC, “Sixth Annual Announcement,” 6.
47. John S. Haller, Jr., Medical Protestants: The Eclectics in American Medicine,
1825–1939 (Carbondale: Southern Illinois University Press, 1994), 158.
48. See, for example, Woman’s Medical College of Pennsylvania, “First Annual
Announcement of the Female Medical College of Pennsylvania for the session of
1850–51 . . . ,” MCP Collection, ASCWM:
The Anatomical Rooms will be furnished with every convenience and kept strictly
private.
They will be under the supervision of the Professor of Anatomy, aided by competent
female assistants. (12)
49. Quoted in Charles E. Rosenberg, The Care of Strangers: The Rise of America’s
Hospital System (New York: Basic Books, 1987), 156; Pennsylvania Hospital, Minute
Book of the Board of Managers, minutes for Nov. 28, 1855, R11D12, HLPH.
50. T. L. Savitt, “‘A Journal of Our Own’: The Medical and Surgical Observer at
the Beginnings of an African-American Medical Profession in Late Nineteenth Cen-
tury America,” part 2, Journal of the National Medical Association 88, no. 2 (Feb.
1996): 115–22.
242
51. Rebecca Crumpler, A Book of Medical Discourses in Two Parts (Boston: Cash-
man, Keating & Co., 1883), 114–16, Historical Collection, National Library of Medi-
cine, Washington, D.C.
52. Rosi Braidotti, Nomadic Subjects: Embodiment and Sexual Difference in Con-
temporary Feminist Theory (New York: Columbia University Press, 1994), 199.
53. WMC, “Sixth Annual Announcement,” 8, 1.
54. WMC, “Tenth Annual Announcement,” 5.
55. WMC, “Twenty-first Annual Announcement,” 4.
56. Judson, “Address in the Memory of Ann Preston,” 41–42.
57. Judson, “Address in the Memory of Ann Preston,” 16.
58. Foster, Ann Preston, 262.
59. In an anonymous pamphlet titled Men and Women Medical Students and
the Woman Movement (Apr. 1870), we read, “Filling the public office of Dean to
a college and bellwether to the flock, suggests to our mind, either that the cure by
Dr. Kirkebride [sic] was incomplete, or that the disease has revived in pantaloons,”
an eerie invocation of the cross-dressing theme. The pamphlet is bound with the
Minute Book of the Board of Managers of the Pennsylvania Hospital, R11D12,
HLPH.
60. Preston, “Nursing the Sick,” 2.
61. Judson, “Address in the Memory of Ann Preston,” 20.
62. Garber, Vested Interests, 16.
63. Alsop, History of the Woman’s Medical College, 61.
64. Foster, Ann Preston, 302.
65. Woman’s Hospital of Pennsylvania, Board of Managers Minutes, Sept. 1 and
Sept. 22, 1864, Hospitals, MCP-G3a, ASCWM.
66. Philadelphia County Medical Society, “Proceedings,” in the Philadelphia Med-
ical and Surgical Reporter, “Report of Committee on Status of Female Physicians,
Philadelphia County Medical Society,” 16, no. 13 (Mar. 30, 1867): 256–62.
67. Philadelphia County Medical Society, “Proceedings,” in the Philadelphia Med-
ical and Surgical Reporter, “Report of Committee on Status of Female Physicians,”
260, 258.
68. Preston, “Women as Physicians,” 1.
69. Preston, “Women as Physicians,” 2–4.
71. Mary P. Ryan, Womanhood in America: From Colonial Times to the Present,
3d ed. (New York: Franklin Watts, 1983), 113–67.
CHAPTER 4. LEARNING TO WRITE MEDICINE
1. For a general history of nineteenth-century medical education, see Kenneth

Ludmerer, Learning to Heal: The Development of American Medical Education (Bal-
timore: Johns Hopkins University Press, 1985). For a specific account of the curricu-
lum at the University of Pennsylvania, see Thomas Huddle, “Competition and Re-
243
form at the University of Pennsylvania, 1847–77,” Journal of the History of Medicine

and Allied Sciences 51, no. 3 (July 1996): 251–92.
2. Joseph Longshore, letter to Thomas Longshore, Jan. 24, 1834, Longshore Pa-
pers, ASCWM.
3. For struggles to define the thesis requirements in the University of Pennsylva-
nia School of Medicine at the end of the eighteenth century, see Lisa Rosner, “Stu-
dent Culture at the Turn of the Nineteenth-Century: Edinburgh and Philadelphia,”
Caduceus 10, no. 2 (autumn 1994): 65–86.
4. University of Pennsylvania Medical Faculty, “Report on the Medical Depart-
ment of the University of Pennsylvania,” for the Session of 1851–52, to the Alumni of
the School, by the Medical Faculty (Philadelphia: Lippincott, Grambo and Company,
1852), unpaginated, bound with University of Pennsylvania School of Medicine pam-
phlets (M378.748 PZME.8), Rare Book and Manuscript Library, University of Penn-
sylvania, Philadelphia.
5. Leo J. O’Hara, An Emerging Profession: Philadelphia Doctors, 1860–1900
(New York: Garland, 1989), 27–28.
6. Daniel Drake, Practical Essays on Medical Education and the Medical Pro-
fession in the United States (Cincinnati: Roff and Young, 1832), reprinted in Gert
Brieger, ed., Medical America in the Nineteenth Century: Readings from the Litera-
ture (Baltimore: Johns Hopkins University Press, 1972), 13.
7. Boston Herald, Sept. 10, 1847, quoted in Thomas Neville Bonner, To the Ends
of the Earth: Women’s Search for Education in Medicine (Cambridge, Mass.: Harvard
University Press), 17.
8. See, for example, F. Campbell Stewart, “The Actual Condition of the Medical
Profession in This Country; with a Brief Account of Some of the Causes Which Tend
to Impede Its Progress, and Interfere with Its Honors and Interests,” New York Jour-
nal of Medicine 6 (1846): 151–71, reprinted in Brieger, Medical America, 62–74.
9. Medical and Surgical Reporter (Philadelphia), “Minutes of the Medical Soci-
ety of the State of Penn’a.,” (June 18, 1870): 529.
10. Letter from D. L. Rogers, quoted in Andrew Boardman, “An Essay on the
Means of Improving Medical Education and Elevating Medical Character,” re-
printed in Brieger, Medical America, 27–28.
11. John Dickson Bruns, Life, Its Relations, Animal and Mental: An Inaugural
Dissertation (Charleston, S.C.: Steam Power Press of Walker, Evans, and Co.,
1857), CPP.
12. Elisha K. Kane, M.D., Experiments on Kiesteine, with Remarks on Its Applica-
tion to the Diagnosis of Pregnancy (Philadelphia: Medical Faculty of the University
of Pennsylvania, 1842), reprinted from the American Journal of the Medical Sciences
4 (1842): 13–38, CPP.
13. Oliver Wendell Holmes, “Report of the Committee on Medical Literature,”
Transactions of the American Medical Association 1 (1848): 249–88.
14. WMC, “Third Annual Announcement, of the Female Medical College of
Pennsylvania for the Session of 1852–53,” MCP Collection, ASCWM.
15. WMC, Faculty Minutes, Feb. 17–19, 1859, MCP Collection, ASCWM. For
the enormous range of nineteenth-century approaches to literacy instruction for
244
women, see Catherine Hobbs, ed., Nineteenth-Century Women Learn to Write

(Charlottesville: University Press of Virginia), 1995.
16. For a list of publications of the early graduates of the Woman’s Medical Col-
lege of Pennsylvania, see Clara Marshall, The Woman’s Medical College of Pennsylva-
nia: An Historical Outline (Philadelphia: P. Blakiston, 1897).
17. See the list of theses in University of Pennsylvania Medical Faculty, “Report
on the Medical Department of the University of Pennsylvania,” for the Session of
1851–52.
18. The full titles of the theses I have studied in the register of health from the
University of Pennsylvania, all of which are in the Rare Book and Manuscript Library
of the University of Pennsylvania, are as follows:
Joshua Allen. “An Essay on Organic Life Force” for the Degree of Doctor of Medi-
cine, by Joshua G. Allen, County of Delaware, State of Pennsylvania. Preceptor Dr.
Charles J. Morton of Pa. Duration of studies three years. Presented 2nd mo. 15th,
1850.
Thomas Corson, “An Essay on Health versus Fashion” for the Degree of Doctor
of Medicine, in the University of Pennsylvania. By Thomas J. Corson, of New Hope,
Bucks county, State of Pennsylvania. Residence in city, 293 Race Stre., Preceptor,
Chas. Foulke, M.D., Duration of studies, three and a half years. Presented, Jany
18th, 1851.
Abram Smith. “An Essay on the Moral and Physical Education of Females” For
the Degree of Doctor of Medicine in the University of Pennsylvania by Abram Smith,
of Easton, Northampton County, State of Pennsylvania, Residence No. 91 South
Eighth Street, Philada. Preceptor S. Morton Zulich, M.D. Duration of Studies 3
years. Presented Feby 1850.
As in the discussion of medical forensics (chap. 2), I have reproduced the orthog-
raphy of thesis title pages as closely as possible, adding quotation marks to designate
the main title.
I would also categorize in the register of health such theses as James Brown (1851),
“Physical Effects of Heat and Cold”; John Cummings (1851), “Medical Reform”;
B. Fancuil Craig (1851), “Phenomena of Human Vision”; Frisby Newcomer (1851),
“Origin of Medicine, &c.”; James Wilson (1851), “Effects of Habit.”
19. Transactions of the Medical Society of New Jersey, Thomas Corson obituary
(Newark, N.J.: Hardham, 1879), 209; Thomas Corson, Physician and Patient: Ad-
dress Delivered before the State Medical Society of New Jersey (1869), by Thos. J.
Corson, M.D., President of the Society, pamphlet, 1869, CPP.
20. See, for example, Michael Halloran, “Rhetoric in the American College Cur-
riculum: The Decline of Public Discourse,” Pre/Text 3 (1982): 245–69; James Berlin,
Writing Instruction in Nineteenth-Century American Colleges (Carbondale: South-
ern Illinois University Press, 1984); Albert Kitzhaber, Rhetoric in American Colleges,
1850–1900 (Dallas: Southern Methodist University Press, 1990); Susan Miller, Tex-
tual Carnivals: The Politics of Composition (Carbondale: Southern Illinois University
Press, 1991); Nan Johnson, Nineteenth Century Rhetoric in North America (Carbon-
dale: Southern Illinois University Press, 1991); and the documents collected in John
C. Brereton, ed., The Origins of Composition Studies in the American College, 1875–
245
1925, a Documentary History (Pittsburgh: University of Pittsburgh Press, 1995).

Anne Ruggles Gere’s Intimate Practices: Literacy and Cultural Work in U.S. Wom-
en’s Clubs, 1880–1920 (Urbana: University of Illinois Press, 1997) investigates the
alternate practices of women’s clubs.
21. Ann La Berge and Mordechai Feingold, eds., French Medical Culture in the
Nineteenth Century (Amsterdam and Atlanta, Ga.: Rodopi, 1994); therein, see espe-
cially Jacalyn Duffin, “Private Practice and Public Research: The Patients of R. T. H.
Laennec” (118–49); and Ann La Berge, “Medical Microscopy in Paris, 1830–65”
(296–326).
System (New York: Basic Books, 1987).
23. M. A. K. Halliday and J. R. Martin, Writing Science: Literacy and Discursive
Power (Pittsburgh: University of Pittsburgh Press, 1993).
24. Halliday and Martin, Writing Science, 61.
25. Rosenberg, Care of Strangers, see esp. chap. 3. For a more focused account,
oriented to changes in therapy, see John Harley Warner, The Therapeutic Perspec-
tive: Medical Practice, Knowledge, and Identity in America, 1820–1885, reprint ed.
(Princeton, N.J.: Princeton University Press; original publication, Cambridge, Mass.:
Harvard University Press, 1986). For early responses to these theories, see Morris
Vogel and Charles Rosenberg, eds., The Therapeutic Revolution: Essays in the Social
History of American Medicine (Philadelphia: University of Pennsylvania Press, 1979);
and Charles Rosenberg and Janet Golden, eds., Framing Disease: Studies in Cultural
History (New Brunswick, N.J.: Rutgers University Press, 1992).
26. Rosenberg, Care of Strangers, chap. 3.
27. For the discourses of scientific medicine, see Michel Foucault, The Birth of
the Clinic: An Archaeology of Medical Perception (New York: Random House, 1973).
For a historical treatment of scientific medicine in the United States, see the works
cited above and Rosenberg, Care of Strangers, chap. 6.
28. Halliday and Martin, Writing Science, 65.
29. Corson, “Health versus Fashion,” 12–14.
30. Corson, “Physician and Patient,” 7.
31. For a discussion of transactional writing by students for teachers, see James
Britton, The Development of Writing Abilities (11–18) (London: Macmillan Educa-
tion, 1975).
32. Corson, “Health versus Fashion,” 20. A whole chapter might be written about
such spellings as Corson’s develope, common enough in all these theses, both from
Penn and the WMC texts, to seem standard. Nonstandard spellings of both technical
and nontechnical terms are common in many theses, as they are in many handwritten
contemporary documents.
33. See Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the
Social Experience of Illness in American History (New York: Basic Books, 1994).
Since the term phthisis could include both tuberculosis and many less serious dis-
eases, including pneumonia and bronchitis, the disease was of course confusing and
unpredictable. It could lead to sudden death, linger, go into remission, or be cured.
Both Rothman and Barbara Bates (Bargaining for Life: A Social History of Tuber-
culosis, 1876–1938 [Philadelphia: University of Pennsylvania Press, 1992]) recount
246
many instances of tubercular patients negotiating the management of their disease

with physicians.
34. The Eclectic Medical Journal of Philadelphia, ed. William Paine, M.D., and
Marshall Calkins, M.D., Professor of the Institutes and Practice of Surgery in the
Eclectic Medical College of Pennsylvania, Philadelphia, CPP. See, for example, vol.
3, no. 6 (June 1860), which includes a brief notice in “Miscellany” lamenting how few
people can cook potatoes well. The New York Medical Gazette, on the other hand,
satirically reprinted such notices from irregular publications as evidence of quackery.
35. Samuel Gross, “The Factors of Disease and Death after Injuries, Parturition,
and Surgical Operations,” Reports and Papers, A.P.H.A. 2 (1874–75): 400–14, re-
printed in Brieger, ed., Medical America, 190–200, quotation on 194.
36. For another University of Pennsylvania thesis in the discourse of health, see
Abram Smith’s “Essay on the Moral and Physical Education of Females.” Smith
follows Corson’s organization, nearly topic for topic. The thesis raises interesting
questions about varying cultural norms for plagiarism and originality, an issue re-
cently researched by Candace Spigelman, “Dialectics of Ownership in Peer Writing
Groups,” Ph.D. dissertation, Temple University, Philadelphia, 1996.
37. The following theses are all from the Woman’s Medical College in the reg-
ister of health and are housed in the ASCWM, WMCP Theses, 1851–56. Their title
pages read:
Angenette Hunt. “A Disquisition on the True Physician.” Respectfully submitted
to the Faculty of the Medical College of Pennsylvania, as inaugural Thesis for the
degree of M.D. by Angenette Hunt of Hamilton, N.Y. Term of study 3 years. Precep-
tor Dr. H. N. Hunt. Philadelphia, Nov. 26th, 1851.
Ann Preston. “A Disquicition on General Diagnosis,” Respectfully submitted to
the Faculty of the Female Medical College of Pennsylvania as an Inaugural Thesis
for the Degree of M.D. by Ann Preston of West Grove, Penna, term of study 3 years,
preceptor, N. R. Moseley, M.D., Phila, Nov. 26th, 1851.
Anna M. Longshore [Anna Longshore-Potts]. “A Disquisition on Electricity.” Re-
spectfully submitted to the Faculty of the Female Medical College of Pennsylvania
As an Inaugural Thesis For the Degree of M.D. By Anna M. Longshore of Bucks
County Pa. Period of Study three years. Preceptor J. S. Longshore, M.D. Novem-
ber 1851.
Augusta R. Montgomery. “A Disquisition on the Medical Education of Woman”
Respectfully Submitted to the Faculty of the Female Medical College of Pennsylva-
nia as an Inaugural Thesis for the Degree of Doctor of Medicine. By Augusta R.
Montgomery. Residence: Attica, New York. Term of Study. Three years. Preceptors:
Drs. Hayes and Hadley. Philadelphia, January 1st, 1853.
Maria Minnis. “A Disquisition on Medical Jurisprudence.” Respectfully submitted
to the Faculty of the Female Medial College of Pennsylvania as an Inaugural Thesis
for the Doctorate in Medicine by Maria Minnis of Phelps, New York. Period of Study,
four years. Preceptors, Caleb Bannister M.D. and G. F. Horton. Philadelphia, Janu-
ary 10th 1853.
38. WMC, Deceased Alumnae Files, Angenette A. Hunt, ASCWM. This informa-
tion is from a newspaper obituary, no author or newspaper name given, dated Dec.
29, 1901.
247
39. A. Hunt, “True Physician,” 3. Hunt’s punctuation, relying heavily on dashes

joined to commas, is more colloquial than that of most of the theses produced at the
University of Pennsylvania School of Medicine but not unusual for theses produced
at the Woman’s Medical College of Pennsylvania.
40. See Warner, Therapeutic Perspective, 163.
41. See, for example, the founding statement of the Organization of the American
Eclectic Medical Association of Philadelphia, “for the purpose of informing the pub-
lic of the true resources of all the one idea systems of medicine, and of the great
advantage obtained by combining the important and valuable features of each, into
one general American system of medicine.” This call by Prof. William Paine is quoted
in the Eclectic Medical Journal of Philadelphia, “Organization of the American Eclec-
tic Medical Association of Philadelphia,” 1, no. 4 (April 1858): 166. For a general
account of Eclectic medicine, see John S. Haller, Medical Protestants: The Eclectics
in American Medicine, 1825–1939 (Carbondale: Southern Illinois University Press,
1994).
42. A. Hunt, “True Physician,” 10.
43. A. Hunt, “True Physician,” 10–11.
45. Harriot Kezia Hunt, Glances and Glimpses: Or Fifty Years Social, Including
Twenty Years Professional Life (Boston: Jewett, 1856), 87.
46. Ann Preston, “Valedictory Address to the Graduating Class of the Female
Medical College of Pennsylvania for the Session of 1857–58,” by Ann Preston, M.D.,
Professor of Physiology and Hygiene, 1–2, MCP Deans Files, Preston Papers,
ASCWM.
47. Rachel Gleason, Talks to My Patients: Hints on Getting Well and Keeping Well,
new ed., enlarged with the addition of nineteen “Letters to Ladies” on health, educa-
tion, society, etc. (New York: Holbrook, 1895), 61.
49. A. M. Longshore, “Electricity,” 8, 12.
50. Anna Longshore-Potts, Love, Courtship, and Marriage (Paradise Valley Sani-
tarium, National City, San Diego Co., Calif.: self-published, 1891), ASCWM.
51. WMC, Faculty Minutes I, Dec. 1851. Each faculty member voted whether to
pass or fail each student; the votes were recorded with black and white balls. Anna
Longshore and Angenette Hunt passed with seven white balls apiece.
52. Jacques Lacan, Feminine Sexuality: Jacques Lacan and the école freudienne,
ed. Juliet Mitchell and Jacqueline Rose (New York: Norton, 1985).
53. For accounts of standpoint theory, see Evelyn Fox Keller, “Feminism and Sci-
ence,” in Feminism and Science, ed. Evelyn Fox Keller and Helen Longino (New
York: Oxford University Press, 1996); Sandra Harding, “Rethinking Standpoint Epis-
temology: What Is ‘Strong Objectivity’?” in Feminist Epistemologies, ed. Linda Alcott
and Elizabeth Potter (New York: Routledge, 1993); and Sandra Harding, Whose Sci-
ence? Whose Knowledge? Thinking from Women’s Lives (Ithaca, N.Y.: Cornell Uni-
versity Press, 1991).
54. Evelyn Fox Keller, Reflections on Gender and Science (New Haven, Conn.:
Yale University Press, 1985); for the gender of the medical gaze see Ludmilla Jor-
danova, Sexual Visions: Images of Gender in Science and Medicine between the Eigh-
248
teenth and Twentieth Centuries (New York: Harvester, 1989). None of this argument
should be taken to mean that there was an earlier state of medical writing in which
gender was not reified; see Laurinda Dixon, Perilous Chastity: Women and Illness in
Pre-Enlightenment Art and Medicine (Ithaca: Cornell University Press, 1995).
55. For wax models, see Ludmilla Jordanova, Sexual Visions, 87–111. For flap
anatomies and the reluctance of anatomical atlases to illustrate the female body, see
K. B. Roberts, “The Contexts of Anatomical Illustrations,” in The Ingenious Machine
of Nature: Four Centuries of Art and Anatomy, by Mimi Cazort, Monique Kornell,
and K. B. Roberts (Ottawa: National Gallery of Canada, 1996), 78–92.
56. Mary Ryan, Women in Public: Between Banners and Ballots (Baltimore: Johns
Hopkins University Press, 1990).
57. Jordanova, Sexual Visions, 87.
58. Harding, “Rethinking Standpoint Epistemology: What Is ‘Strong Objectiv-
ity’?” 51.
59. Keller, “Feminism and Science,” 31.
60. Rosenberg, The Care of Strangers, 138–40; and W. F. Bynum, Science and the
Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University
Press, 1994), 130.
61. All theses in the register of medicine at the Woman’s Medical College of Penn-
sylvania are from the ASCWM. The full title pages for the 1851 theses (class of
1852) read:
Susanna H. Ellis. “A Disquisition on the Influence of the Nervous System on the
Functions of Respiration and Digestion.” Respectfully submitted to the Faculty of
the Female M. College of Pennsylvania as an inaugural thesis; for the Degree of
M.D. By Susanna H. Ellis of Philadelphia. Preceptor J. W. Comfort, M.D. Period
of study 3 years, 1851.
Frances Mitchell. “A Disquisition on Chlorosis.” Respectfully submitted to the
Faculty of the Female Medical College of Pennsylvania as an Inaugural Thesis for
the degree of the Doctorate in the Female Medical College of Pennsylvania. By
Frances G. Mitchell of England. Period of Study three years. Preceptor J. F. X. Mc-
Closkey, M.D., Philadelphia, Dec 1st 1851.
Phebe Way. “A Disquisition on Wounds.” Respectfully submitted to the Faculty
of the Female Medical College of Pennsylvania. As an Inaugural Thesis for the De-
gree of M.D. by Phebe M. Way of Chester County, Pennsylvania. Preceptor, J. W.
Comfort.
Hannah Longshore. “A Disquisition on Neuralgia, its Treatments,” respectfully
Submitted to the Faculty of the Female Medical College of Pennsylvania as an Inau-
gural Thesis for the Degree of M.D. by Hannah E. Longshore of Philadelphia. Period
of Study, Three Years. Preceptor, Dr. Joseph S. Longshore. November 1851.
Martha Sawin. “A Disquisition on Anaemia.” Respectfully Submitted to the Fac-
ulty of the Female Medical College of Pennsylvania as an Inaugural Thesis for the
Degree of M.D. by Martha A. Sawin of Boston, Mass. Period of Study 3 years. Pre-
ceptors, E. C. Rolfe, M.D., W. M. Cornell, M.D.
The full title pages of the 1852 theses (class of 1853) in the register of medicine
read as follows:
Charlotte Adams. “Disquisitio De Physiologus Effectis Nutricum A Lactatione
249
Note to Page 100
Nimia.” Verecundie Submittitur ad Professores Feminae Medicinalis Collegii Penn-

sylvaniae, Quasi Inauguratum Propositum Pro Grado Doctoris Medicinae. Per Char-
lotte G. Adams, Bostonae. Praeceptores Guilielmus M. Cornell M.D., Enochus C.
Rolfe, MD., Tempus Studii—Tres Annos. Philadelphia, Januaris Primo Die. Anno-
domini MDCCCLII.
Annah N. S. Anderson. “A Disquisition on General Physiology,” Respectfully Sub-
mitted to the Faculty of the Female Medical College of Pennsylvania as an Inaugural
thesis, for the Degree of Doctorate of Medicine. By Annah N. S. Anderson of Bristol,
Bucks County Pennsylvania. Period of study 3 years. Preceptor Dr. Benjamin Ma-
lone, Philadelphia, January 1853 [underlining on original title page].
Julia A. Beverly. “A disquistion on Iron,” respectfully Submitted to the Faculty of
the Female Medical College of Pennsylvania As an Inaugural Thesis for the Degree
of Doctor in Medicine, January 7th, 1853 by Julia A. Beverly of Prov. Rhode Island.
Preceptors, W. M. Cornell, M.D. and E. C. Rolfe, M.D. Period of study three years.
Hannah W. Ellis. “A Disquisition on Labor.” Respectfully submitted to the Faculty
of the Female Medical College of Pennsylvania as an Inaugural Thesis for the Degree
of Doctorate of Medicine by Hannah W. Ellis of Pennsylvania. Period of study 3
years. Preceptor Philadelphia, 1853.
Henrietta W. Johnson. “A disquisition on the Skin and its Functions”: Respectfully
gural thesis For the degree of M.D. by Henrietta W. Johnson of New Jersey. Precep-
tor I. W. Redfield M.D., Term of Study Three Years.
Margaret Richardson. “A Disquisition on Phthisis Pulmonalis,” respectfully Sub-
mitted to the Faculty of the Female Medical College of Pennsylvania as an Inaugural
Theses for the Degree of the Doctorate in Medicine. By Margaret Richardson of
Pennsylvania. Period of Study, three years, Preceptor, J. S. Longshore, M.D., Phila-
delphia, December 30th, 1852.
The theses from the University of Pennsylvania in the register of medicine that will
be discussed in this chapter are all found in the Rare Book and Manuscript Library,
University of Pennsylvania (PA). They are:
S. Wylie Crawford. “An Essay on Hypertrophy and Atrophy” for the Degree of
Doctor of Medicine in the University of Pennsylvania. by S. Wylie Crawford of Phi-
lad., State of Pennsylvania. Residence—Philadelphia, Arch St. above. Preceptor,
Wm. E. Horner, M.D., Duration of Studies, three years; Presented, February 4th,
1850.
Jesse A. Rivins. “An Essay on Auscultation in the Diagnosis of Pulmonary Disease.”
For the Degree of Doctor of Medicine in the University of Pennsylvania by Jesse A.
Rivins of Rutherford County, Tennessee. Preceptors. Watson and Wendel. Duration
of studies 3 years and 4 months. Presented Jan 22nd, 1850 [note on front of thesis
reads “ad eundum Louisville,” the usual nomenclature for a student who had begun
medical training elsewhere].
John W. Sale. “An Essay on Haemoptysis” For the Degree of Doctor of Medicine
in the University of Pennsylvania, by John W. Sale, of Bedford County, State of Vir-
ginia. Residence in the City No 13th Filbert St. Preceptor R. A. Sale, M.D. Duration
of Studies 3 years. Presented on the 15th of Jany, 1850.
62. WMC, Alumnae Association, Transactions of the Thirty-fourth Annual Meet-
250
ing of the Alumnae Association of the Woman’s Medical College of Pennsylvania, May
27–28, 1909, Obituaries (Philadelphia: Published by the association, 1909), MCP
Collection, ASCWM. The fullest biography of Richardson is in Theodore W. Bean,
A History of Montgomery County, Pennsylvania, vol. 1 (Philadelphia: Everts and
Peck, 1884), 667–68, MCHS. The same source shows Margaret Richardson as a prac-
ticing physician but not as a member of the Montgomery County Medical Society
(677); members of the county medical society, however, served as her pallbearers in
1909 (Norristown Daily Herald, May 18, 1909, MCHS). Bean’s history is the source
for Richardson’s obituary in the Norristown Daily Herald.
63. Bynum (Science and the Practice of Medicine) offers valuable caution against
dichotomizing traditional and scientific understandings of disease. For an influential
article on the specificity of disease, see Owei Temkin, “The Scientific Approach to
Disease: Specific Entity and Individual Sickness,” in The Double Face of Janus and
Other Essays in the History of Medicine (Baltimore: Johns Hopkins University Press,
1977), 441–55.
64. John Harley Warner, Against the Spirit of System: The French Impulse in
Nineteenth-Century American Medicine (Princeton, N.J.: Princeton University Press,
1998), 185–206.
65. Bynum, Science and the Practice of Medicine, 17.
66. Rothman, Living in the Shadow of Death.
67. Richardson, “Phthisis Pulmonalis,” 8.
69. For physiognomy, see Barbara Stafford, Body Criticism: Imaging the Unseen
in Enlightenment Art and Medicine (Cambridge, Mass.: MIT Press, 1991); and Chris-
topher Rivers, Face Value: Physiognomical Thought and the Legible Body in Mari-
vaux, Lavater, Balzac, Gautier, and Zola (Madison: University of Wisconsin Press,
1994).
70. William Carpenter, Principles of Human Physiology with the Chief Applica-
tions to Psychology, Pathology, Therapeutics, Hygiéne, and Forensic Medicine, by
William B. Carpenter, M.D., F.R.S., F.G.S, ed. with additions by Francis Gurney
Smith, M.D., new American from the last London ed. (Philadelphia: Blanchard and
Lea, 1856), 190.
71. Richardson, “Phthisis Pulmonalis,” 10–11.
78. Kane, Experiments on Kiesteine, 14.
80. Bonner, To the Ends of the Earth, 15–16.
81. A cognate “disguised” thesis from the Department of Medicine at the Univer-
sity of Pennsylvania, written in the register of health, has as its official title “An Essay
on Organic Life Force.” On the first inside page, the author, Joshua G. Allen, has
painstakingly inscribed, “An essay on Organic Life force: an Independent Vital Prin-
251
ciple contended for and explained upon a New Theory.” See Allen, “An Essay on
Organic Life Force.”
82. Way discussed the general effects of various kinds of wounds on the body,
recommended specific materials for and placements of sutures, and offered advice
on the course of treatment for wound patients. But Robert Liston’s Elements of Sur-
gery, ed. Samuel D. Gross (Philadelphia: Ed. Barrington and Geo. Haswell, 1846),
one of the recommended surgery texts, discussed wounds in detail (167 and passim),
describing the effects of laceration on various levels of vascular tissue, the process of
coagulation, and possible complications of treatment. Another recommended text,
Alf. A. L. M. Velpeau’s New Elements of Operative Surgery, first American from the
last Paris ed. (New York: Langley, 1845), offered, besides an inimitable chapter on
the “sang-froid of the surgeon,” a discussion of the differences between lacerations
of veins and those of arteries.
83. Sawin, “Anaemia,” 6, quoting Carpenter, Principles of Human Physiology.
84. This passage is found in the 1856 edition of Carpenter, Principles of Human
Physiology, which would not, of course, have been available to students graduating
in 1853; I have not been able to locate the earlier edition of this text, but the coher-
ence between Sawin’s quotation and Carpenter’s treatment of blood constituents
leads me to believe that this section did not change substantially.
85. For the classic critique of “male as norm,” see Helen Longino and Ruth
Doell, “Body, Bias, and Behavior: A Comparative Analysis of Reasoning in Two Areas
of Biological Science,” Signs: Journal of Women in Culture and Society 9, no. 2 (win-
ter 1983): 206–27.
86. Carpenter, Principles of Human Physiology, 189.
87. Gulielma Fell Alsop, History of the Woman’s Medical College, Philadelphia,
Pennsylvania (1850–1950) (Philadelphia: Lippincott, 1950), 35.
88. H. K. Hunt, Glances and Glimpses, 370.
89. WMC, Faculty Minutes, Nov. 18, 1850.
90. Alsop, History of the Woman’s Medical College, 307; Medical and Surgical
Reporter (Philadelphia), obituary, Francis McCloskey, n.s. 2 (1859): 189. Steven
Peitzman drew my attention to this notice.
91. See Joseph Longshore, “The Ovular Theory of Menstruation, and Its His-
tory,” Eclectic Medical Journal of Philadelphia 8, no. 6 (June 1865): 241–45.
92. H. W. Ellis, “Labor,” 9.
93. WMC, Faculty Minutes, Jan. 19, 1853.
94. H. W. Johnson, “Skin and its Functions,” 5.
95. Sale, “Haemoptysis,” 9–10.
96. Sale, “Haemoptysis,” 6.
98. O’Hara, An Emerging Profession, 38.
99. John P. Richardson, “Enteric or Typhoid Fever,” Department of Medicine,
University of Pennsylvania, Preceptor H. D. W. Pawling, Department of Medicine.
Feb 17, 1863, PA.
100. Edgar E. Hume, Orthinologists of the US Army Medical Corps: Thirty-Six
Biographies (Baltimore: Johns Hopkins University Press, 1942), 90–104.
101. Hume, Ornithologists, 101.
252
102. Crawford, “Hypertrophy and Atrophy,” 1–2.

103. John S. Cook, “An Essay on Diabetes” for the Degree of Doctor of Medicine,
by John S. Cook, Easton, Northampton County, Penna., Preceptor Lewis C. Cook,
M.D., 1850, 22, Rare Book and Manuscript Library, University of Pennsylvania.
104. Rivens, “Diagnosis of Pulmonary Disease,” 21.
105. Black Women Physicians Project, 1864–1995, Carolyn Still Wiley Anderson
file, ASCWM.
106. Caroline V. Wiley, “A Thesis on Fibromata,” Presented to the Faculty of the
Woman’s Medical College of Pennsylvania for Degree of Doctor of Medicine by Car-
oline Wiley, Philadelphia, Session of 1877–78.
107. Matthew Anderson, Presbyterianism. Its Relation to the Negro, Illustrated
by The Berean Presbyterian Church, Philadelphia, with Sketch of the Church and
Autobiography of the Author (Philadelphia: John McGill, White, and Co., 1897), 251.
108. See The Berean Manual Training and Industrial School (Philadelphia: n.d.,
probably 1914); and The Berean Manual Training and Industrial School (Philadel-
phia, 1907–8); both in the Black Women Physicians Project, Anderson file, ASCWM.
109. Caroline V. Wiley-Anderson, “Popliteal Aneurism,” in WMC, Alumnae Asso-
ciation, Report of the Proceedings of the Thirteenth Annual Meeting of the Alumnae
Association of the Woman’s Medical College of Pennsylvania, Mar. 16, 1888 (Philadel-
phia: Rodgers Printing, 1888), 33–35, MCP Collection, ASCWM.
110. Black Women Physicians Project, 1864–1995, Eliza Grier file, “Coal Black
Woman Doctor,” North American Medical Review, MCP clipping file, Acc. #133,
ASCWM.
111. Ruth Lathrop, letter, Jan. 6, 1898, Black Women Physicians Project, Grier file.
112. The “emancipated slave” quotation is from Grier’s letter to the president and
proprietor of the Woman’s Medical College, dated Dec. 6, 1890, Black Women Physi-
cians Project, Grier file. An account of Grier’s earlier education can be found in Dar-
lene Clark Hine, Black Women in America: An Historical Encyclopedia (Blooming-
ton: Indiana University Press, 1994). The story of Grier supporting her medical
education by picking cotton is from Dorothy Salem, ed., African American Women:
A Biographical Dictionary (New York: Garland, 1993). All documents from Black
Women Physicians Project, Grier file.
113. Eliza Grier, letter to Susan B. Anthony, Mar. 7, 1901, Black Women Physi-
cians Project, Grier file.
114. Georgia Fraser-Goins, “Miss Doc,” 110, 111, Georgia Fraser-Goins Collec-
tion, Moorland-Spingarn Research Center, Manuscript Division, Howard University
Library, quoted in Gloria Moldow, Women Doctors in Gilded-Age Washington: Race,
Gender, and Professionalization (Urbana: University of Illinois Press, 1987), 130.
115. Wiley, “Fibromata,” 44.
116. Wiley, “Fibromata,” 1–2.
119. Wiley, “Fibromata,” 36–37.
120. Wiley, “Fibromata,” 20, 42.
122. WMC, Alumnae Association, Report of the Proceedings of the Nineteenth An-
253
nual Meeting of the Alumnae Association of the Woman’s Medical College of Pennsyl-
vania, May 9–10, 1894 (Philadelphia: Buchanan, 1894), 104.
123. WMC, Alumnae Association, Report of the Proceedings of the Nineteenth An-
nual Meeting, 104.
124. Georgiana Young, “A Thesis on Opium,” Presented to the Faculty of the
Woman’s Medical College of Pennsylvania, for degree of Doctor of Medicine by
Georgie E. Young, Philadelphia, Session of 1877–78. ASCWM.
125. Dr. C. Bruce Lee, letter to the dean of the Woman’s Medical College of
Pennsylvania, Apr. 20, 1964, Black Women Physicians Project, Georgiana Young
file, ASCWM.
126. Young, “Opium,” 40.
127. Young, “Opium,” 19–20.
128. Young, “Opium,” 27.
129. Juan F. Bennett, “Sanitary Chemistry,” Submitted to the Faculty and Corpo-
rators of the Woman’s Medical College for the Degree of Doctor of Medicine, Juan
F. Bennett, 1888. ASCWM.
131. Bennett, “Sanitary Chemistry,” 8, 9.
132. Bennett, “Sanitary Chemistry,” 15.
135. Regina Morantz-Sanchez, Sympathy and Science: Women Physicians in
American Medicine (New York: Oxford University Press, 1985).
CHAPTER 5. INVISIBLE WRITING II: HANNAH LONGSHORE AND

THE BORDERS OF REGULARITY
1. Resources on the lives of the Longshore family are collected in the Long-
shore Papers, ASCWM. They include Hannah Longshore’s autobiographical speech,
catalogued as “Autobiography,” and several of her letters. Works in the Longshore
Papers at ASCWM by her husband, Thomas Longshore, include his “Sketch of Her
Early Years,” an undated manuscript; the unsigned “Biography of Hannah E. Long-
shore,” an undated manuscript in two versions; and the unsigned “Biography of Jo-
seph Skelton Longshore,” an undated manuscript in two versions; both of the un-
signed manuscripts are in Thomas Longshore’s handwriting. Thomas E. Longshore’s
“History of the College,” an undated manuscript notebook catalogued as his “Autobi-
ography” (file 11), and miscellaneous clippings, articles, and correspondence are also
included in the Longshore Papers. The New York Academy of Medicine holds Jane
Campbell’s “Sketch of the Life of Dr. Hannah Longshore, a Pioneer Woman Physi-
cian of Philadelphia,” manuscript dated Oct. 29, 1901 (date crossed out).
Additional Longshore family letters and publications by Thomas Longshore are at
the Friends Historical Library of Swarthmore College. The Friends Historical Li-
brary includes Thomas Longshore’s published works, the pamphlets “The Christ”
Interpreted, signed T. E. L. (Philadelphia, July 1884), 3 pages; Father, Son, and Holy
254
Notes to Page 122
Ghost, by T. E. Longshore (n.d., n.p.), 22 pages; The Spiritual Religion of Jesus and
Salvation by Christ. Not Judaism nor Paganism; neither Greek nor Roman Mythol-
ogy; Nor the Religion of Christianity as Taught by the Church in Ancient or Modern
Times, signed T. E. L. (Philadelphia: John Hiestand, Printer, July 1884), 15 pages;
and Our Lord and Savior Jesus Christ, by T. E. Longshore (Philadelphia, Mar. 1888).
Finally, the Friends Historical Library includes both Thomas Longshore’s George
Fox Interpreted: The Religion, Revelations, Motives and Mission of George Fox Inter-
preted in the Light of the Nineteenth Century and Applied to the Present Condition
of the Church (Philadelphia: self-published, 1881); and his major work, The Higher
Criticism in Theology and Religion Contrasted with Ancient Myths and Miracles as
Factors of Human Evolution and Other Essays on Reform (New York: Somesby,
1892).
Joseph Longshore, brother of Thomas Longshore and brother-in-law of Hannah
Longshore, is the author of the following: The Principles and Practice of Nursing,
or a Guide to the Inexperienced (Philadelphia: Merrihew and Thompson, 1842);
The Philadelphia System of Obstetrics (Philadelphia: University Publication Society,
1868); Woman and Her Maladies: The Little Book of Forbidden Knowledge (Philadel-
phia: Grant, Faires, and Rodgers, 1878); and The Centennial Liberty Bell (Philadel-
phia: Claxton, Remsen and Haffelfinger, 1876); all can be found in the general col-
lection of the University of Pennsylvania Library but are also widely held. His
“Introductory Lecture, delivered before the class, at the opening of the Female Med-
ical College of Pennsylvania, Oct. 12, 1850” was published (Philadelphia: Young,
1850), as was his “Valedictory Address delivered before the graduating class, at the
first annual commencement of the Female Medical College of Pennsylvania, held at
the Musical Fund Hall, Dec. 30, 1851” (Philadelphia: Published by the graduates,
1852); both are in the collections of the ASCWM and CPP. The Longshore Papers
at the ASCWM include several of his early letters.
Anna Longshore-Potts, sister of Joseph and Thomas and sister-in-law of Hannah
Longshore, is the author of Love, Courtship, and Marriage (Paradise Valley Sanitar-
ium, National City, San Diego County, Calif.: self-published, 1891), ASCWM; and
Discourses to Women on Medical Subjects (London: self-published, 1897), ASCWM.
2. For short biographies of the three Myers sisters, see Fredrick C. Waite, “The
Three Myers Sisters—Pioneer Women Physicians,” Medical Review of Reviews (Mar.
1933): 1–7. For Mary Frame Myers Thomas’s connections to suffrage journals, see
Margaret Hope Bacon, Mothers of Feminism: The Story of Quaker Women in
America (New York: Harper and Row), 90–91, 141.
3. A note on Anna Longshore-Potts is added, on a small piece of paper, to Thomas
Longshore’s undated manuscript notebook, catalogued as his “Autobiography.”
4. WMC, Alumnae Association, Transactions of the Thirty-eighth Annual Meeting
of the Alumnae Association of the Woman’s Medical College of Pennsylvania, June
5–6, 1913 (Philadelphia: Published by the association, 1913), 38, MCP Collection,
ASCWM.
5. Included among the Longshore Papers in the ASCWM are Lucretia Blanken-
burg, “Notes on an Interview with Mrs. Blankenburg” (no date or interviewer given).
Here, Lucretia Blankenburg characterizes her mother as “a very conscientious
woman of great hypnotic power. [She] hypnotized a child once unconsciously and
255
Notes to Page 124–125
had to get another doctor to awaken the child.” Mrs. Blankenburg speaks of Hannah
Longshore’s dedication, of her homeopathic tendencies, and ascribes to her a rivalry
with Ann Preston: “Ann Preston, a school teacher friend of Dr. Longshore and a
diligently trained Quaker, graduated the same time she did from the WMC. Dr. Pres-
ton was very frail. Went to a sanitarium. Mentally off. Was cured and became con-
nected with the College. . . . Very jealous of Dr. Longshore. Dr. Longshore won out.”
She speculates that Hannah Longshore developed strength in her arms while driving
her own horse that helped her to use forceps in a delivery, even though Ann Preston
said it was not “ladylike” for Dr. Longshore to drive her own horse. Blankenburg
concludes, “All the women that persecuted Dr. Longshore so are dead.”
6. WMC, Alumnae Association, Report of the Proceedings of the Seventeenth An-
nual Meeting of the Alumnae Association of the Woman’s Medical College of Pennsyl-
vania, May 6–7, 1892 (Philadelphia: Smith and Salmon, 1892), 125, MCP Collection,
ASCWM.
7. The Woman’s Medical College toasts were not usually published, but an ac-
count of the toasts and replies for the first alumnae supper can be found in the WMC,
Alumnae Association, Report of Proceedings of the Seventeenth Annual Alumnae
Meeting, and the names of the toast-givers and their topics were often published by
the alumnae (see 172–90).
nual Alumnae Meeting, 127.
nual Alumnae Meeting, 178, 179.
10. Philadelphia Inquirer, “Reunion, University of Pennsylvania,” clipping dated
Dec. 20, 1875, in the William Pepper Papers, PA.
11. Bacon, Mothers of Feminism; Karlyn Kohrs Campbell, Man Cannot Speak for
Her, vol. 1: A Critical Study of Early Feminist Rhetoric, vol. 2: Key Texts of the Early
Feminists (New York: Praeger, 1989).
12. See Ann Braude, Radical Spirits: Spiritualism and Women’s Rights in Nine-
teenth Century America (Boston: Beacon, 1989); and A. Owen, The Darkened Room:
Women, Power, and Spiritualism in Late Victorian England (Philadelphia: University
of Pennsylvania Press, 1990).
13. Campbell, Man Cannot Speak for Her, vols. 1 and 2.
14. This speech exists as an untitled, undated holograph, in four versions: one
final draft and three preliminary drafts, collected in the Longshore Papers as Hannah
Longshore, “Autobiography,” ASCWM. The final manuscript begins “Madam toast
Mistress and co workers,” and internal references date it at about 1895. In her
unpublished “Sketch of the Life of Dr. Hannah Longshore,” held at the New York
Academy of Medicine, Jane Campbell tells the story of Longshore, “nearly fifty
years after she had graduated from the infant Woman’s Medical College,” arising
“at the Banquet now given annually by the Alumnae of the College, to answer the
Toast ‘Memories of Early Years.’” Campbell asserts that Longshore’s reminiscences
of the “days of Auld Lang Syne” made “one of the special features of the occasion.”
In date, form, and topic, the manuscript seems coherent with Campbell’s account;
the manuscript is surely a toast, and there is no other likely context in which
a woman physician would have given such a speech. It is therefore very likely
256
that Longshore’s manuscript was a reply to a toast given at the alumnae

banquet.
15. In quoting Hannah Longshore throughout the chapter, I’ve presented the
punctuation and spelling exactly as they appeared in the original sources.
16. In fact, although the charter of the Woman’s Medical College was often in-
voked in its early history, successive archivists and institutional historians have never
located that document.
17. Harold J. Abrahams, Extinct Medical Schools of Nineteenth-Century Philadel-
phia (Philadelphia: University of Pennsylvania Press, 1966).
18. Joseph Longshore, “Woman,” Eclectic Medical Journal of Philadelphia 8, no. 1
(Jan. 1865): 14–19; and his “History of Obstetrics,” Eclectic Medical Journal of Phila-
delphia 8, no. 3 (Mar. 1865): 117–20; 8, no. 4 (Apr. 1865): 160–63; 8, no. 5 (May
1865): 1–97.
19. T. Longshore, “History of the College,” 28–29.
20. Rev. H. B. Elliot, “Woman as Physician,” in Eminent Women of the Age: Being
Narratives of the Lives and Deeds of the Most Prominent Women of the Present Gen-
eration, by James Parton and others (Hartford, Conn.: S. M. Betts and Company,
1868), 544.
21. Thomas and Hannah Longshore, letter to “you all,” May 10, 1850, Longshore
Papers, Family Correspondence file, ASCWM.
22. T. Longshore, “Autobiography,” 95–100.
23. The story was dramatized in a radio play suggested by Lucretia Blankenburg,
described in the Philadelphia Club of Advertising Women, “Notes of Philadelphia
Friendship Dinner,” typescript, May 2, 1936, Longshore Papers, ASCWM.
24. Ella Upham, “Women in Medicine,” North American Journal of Homeopathy
reprint, no date, 3.
25. Upham, “Women in Medicine,” 5–6.
26. Warner, Therapeutic Perspective, 151.
27. T. Longshore, “Autobiography,” 106.
28. J. Longshore, “A Valedictory Address,” 4.
31. For the literature on women and autobiography, see Virginia Brereton, From
Sin to Salvation: Stories of Women’s Conversions, 1800 to the Present (Bloomington:
Indiana University Press, 1991); Mary Jean Corbett, Representing Femininity:
Middle-Class Subjectivity in Victorian and Edwardian Women’s Autobiographies
(New York: Oxford University Press, 1992); Susan Stanford Friedman, “Women’s Au-
tobiographical Selves,” in The Private Self: Theory and Practice of Women’s Autobio-
graphical Writings, ed. Shari Benstock (Chapel Hill: University of North Carolina
Press, 1988), 34–62; Estelle Jelinek, The Tradition of Women’s Autobiography: From
Antiquity to the Present (Boston: Twayne, 1986); and her Women’s Autobiography:
Essays in Criticism (Bloomington: Indiana University Press, 1980); Linda Peterson,
Victorian Autobiography: The Tradition of Self-Interpretation (New Haven, Conn.:
Yale University Press, 1986); Sidonie Smith, A Poetics of Women’s Autobiography:
Marginality and the Fictions of Self-Representation (Bloomington: Indiana Univer-
sity Press, 1987); Liz Stanley, The Auto/Biographical I: The Theory and Practice
257
of Feminist Auto/Biography (Manchester, England: Manchester University Press,

1992).
For a concise statement of the episodic nature of women’s autobiographies, see
Jelinek, Tradition of Women’s Autobiography, 17. For women’s autobiography as de-
fined by relationship and connection, see, for example, Friedman, “Women’s Auto-
biographical Selves,” 41.
32. Ellen Fussell Cope, in her manuscript “Bits of Background,” quotes from a
letter of Graceanna Lewis on the Indiana antislavery campaign:
Upon the platform with other women of Pendleton sat Rebecca Fussell, with her infant
son in her arms. Frederick Douglass was speaking when the attack of the mob was made.
A large man, wild with excitement, who had forced his way to the platform, with raised
club was rushing toward the speaker to strike him down. On the impulse of the moment,
she held up her child between the two. The man hesitated, looked ashamed, and with a
muttered oath said, “We are not here to fight women and babies,” and turned aside.
Graceanna Lewis letter, no recipient or date noted, quoted in Ellen Fussell Cope,
“Bits of Background,” 6–7, Friends Historical Library of Swarthmore College, SC
045: Alice Fussell, Fussell-Lewis Family Papers, folder 3.
33. Howard Brinton, Quaker Journals: Varieties of Religious Experience among
Friends (Wallingford, Pa.: Pendle Hill, 1972), 1. The journal in question is that of
John Woolman, 1720–70.
34. William Osler, An Alabama Student and Other Biographical Essays, 2d im-
pression (New York: Oxford University Press, 1909). The biography of William Pep-
per (210–31) was delivered at the opening of the 1898 session of the Johns Hopkins
Medical School.
35. Osler once remarked that “human kind might be divided into three groups—
men, women, and women physicians.” See Lillian Welsh, Reminiscences of Thirty
Years in Baltimore (Baltimore: Norman, Remington, 1925), 44–45, quoted in Regina
Markell Morantz-Sanchez, Sympathy and Science: Women Physicians in American
Medicine (New York: Oxford University Press, 1985), 142.
36. See, for example, The Journal, “Gershom M. Fitch: A Biographical Sketch,”
9, no. 9 (May 4, 1881): 67, FHL; or Friends’ Intelligencer, “Life of James Parnel and
Francis Howgill,” 37 (1880): 21–22, 320–24, 337–41, FHL.
37. Peterson, Victorian Autobiography, 124–28.
39. T. Longshore, George Fox Interpreted, 124, 123.
40. T. Longshore, George Fox Interpreted, 24–25.
41. T. Longshore, George Fox Interpreted, 124.
42. T. Longshore, “Autobiography,” 42–43.
43. T. Longshore, “Autobiography,” 70; H. Longshore, “Autobiography,” draft 2.
44. Bruno Latour and Steve Woolgar, Laboratory Life: The Construction of Scien-
tific Facts (Princeton, N.J.: Princeton University Press, 1979).
45. Steven Shapin and Simon Schaffer, Leviathan and the Air Pump: Hobbes,
Boyle, and the Experimental Life (Princeton: Princeton University Press, 1985).
46. Hannah Longshore, “A Case of Conception without Intromission,” Medical
and Surgical Reporter (Philadelphia) 50, no. 22 (May 31, 1884): 700–701.
258

48. Anne Fausto-Sterling, Myths of Gender: Biological Theories about Women
and Men (New York: Basic Books, 1992; originally published, 1985); Emily Martin,
The Woman in the Body: A Cultural Analysis of Reproduction (Boston: Beacon,
1987); Max Charlesworth, “Whose Body? Feminist Views on Reproductive Technol-
ogy,” in Troubled Bodies: Critical Perspectives on Postmodernism, Medical Ethics,
and the Body, ed. Paul A. Komesaroff (Durham, N.C.: Duke University Press,
1995), 125–41.
49. Edward Cass, “Letter from Ohio,” Medical and Surgical Reporter (Philadel-
phia) 50, no. 22 (May 31, 1884): 685.
50. For connections between nineteenth-century scientific writing and literary
and imaginative forms, see Jonathan Smith, Between Fact and Feeling: Baconian Sci-
ence and the Nineteenth-Century Literary Imagination (Madison: University of Wis-
consin Press, 1994).
51. Evelyn Fox Keller, Reflections on Gender and Science (New Haven, Conn.:
Yale University Press, 1985), 86.
52. Sandra Harding, Whose Science? Whose Knowledge? Thinking from Women’s
Lives (Ithaca, N.Y.: Cornell University Press, 1991).
53. Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the So-
cial Experience of Illness in American History (New York: Basic Books, 1994).
54. G. Kass-Simon and Patricia Farnes, Women of Science: Righting the Record
(Bloomington: University of Indiana Press, 1990), xii.
CHAPTER 6. MARY PUTNAM JACOBI: MEDICINE AS WILL AND IDEA
1. The case history is reprinted in Mary Putnam Jacobi, Mary Putnam Jacobi,
M.D.: A Pathfinder in Medicine, ed. Women’s Medical Association of New York City
(New York: Putnam’s Sons, 1925), 501–4, an important and generally reliable source
for Mary Putnam Jacobi’s medical writing (hereafter cited as Jacobi, Pathfinder). A
typescript with Putnam Jacobi’s handwritten corrections is held in the Mary Putnam
Jacobi Collection, Jacobi Papers, folder 35, Schlesinger Library, Radcliffe College.
Putnam Jacobi seems to have sent the case history to a number of physicians, asking
their advice. The corrected typescript differs from the published document in several
details: It is entitled “Case. Description of the Early Symptoms of the Meningeal
Tumor Compressing the Cerebellum. From Which the Writer Dies. Written by Her-
self,” with an epigraph from George Eliot: “The mention of ourselves is always affect-
ing.” The editors of Pathfinder make many small changes in punctuation and arrange-
ment from the typescript, omitting place names and modifying dates; they do not
include the handwritten additions. In the quoted section, the manuscript adds “to
making a plan” after “exertion,” and “his own” before “personal weakness.”
The other easily available published source for Mary Putnam Jacobi’s writing is
Mary Putnam Jacobi, Life and Letters of Mary Putnam Jacobi, ed. Ruth Putnam
(New York: Putnam’s Sons, 1925).
(Note that even though I refer to Putnam Jacobi most often with the combined
259
last names, her sources are all found under “Jacobi” in Works Cited, for that is how
they are routinely catalogued in libraries and archives.)
2. For discussions of “so-called anti-sepsis,” see Mary Putnam Jacobi, “Some De-
tails on the Pathogeny of Pyaemia and Septicaemia,” originally published in the Medi-
cal Record 7 (1872): 73–101 (see the reprint in Jacobi, Pathfinder, 171–200; quotation
above on p. 197); for her discussion of Bright’s disease, see the undated last letter to
the editor (Medical Record 4 [1869–70]: 548–67) in Mary Putnam Jacobi, “Letters to
the Medical Record, 1867–70—Medical Matters in Paris,” signed P. C. M. (Path-
finder, 159–70).
3. Ann Preston, letter to Hannah Monaghan Darlington, May 26, 1833, MCP
Deans Files, Preston Papers, ASCWM. For Putnam Jacobi’s positivism, see her The
Value of Life: A Reply to Mr. Mallock’s Essay “Is Life Worth Living?” (New York:
Putnam’s Sons, 1879).
4. Mary Putnam Jacobi, The Question of Rest for Women during Menstruation,
The Boylston Prize Essay of Harvard University, 1876 (New York: Putnam’s Sons,
1877).
5. For marked and unmarked cross-dressing, see Marjorie Garber, Vested Inter-
ests: Cross-Dressing and Cultural Anxiety (New York: Routledge, 1992), 353–74.
6. Ann Douglas, The Feminization of American Culture (New York: Knopf, 1977).
7. Mary Putnam Jacobi, “Found and Lost,” in Mary Putnam Jacobi, Stories and
Sketches (New York: Putnam’s Sons: 1907), 1–49 (first published in Atlantic Monthly,
Apr. 1860).
8. Mary Putnam Jacobi, autobiographical manuscript, typescript, 1902, Mary
Putnam Jacobi Collection, Jacobi Papers, a-26, folder 3, Schlesinger Library, Rad-
cliffe College.
9. Jacobi, autobiographical manuscript, 4.
10. Jacobi, autobiographical manuscript, 5.
11. See her letters in Mary Putnam Jacobi, Correspondence, Mary Putnam Jacobi
Collection, Jacobi Papers, Schlesinger Library, Radcliffe College: from her grand-
mother, Oct. 1, 1854, on her sense of sin, and her reply Oct. 1854 (folder 5); to her
brother, in 1857, urging conversion (folder 6); to her grandmother, Sept. 15, 1861,
agreeing to continue church attendance (folder 7); the 1854 letters are reprinted in
Jacobi, Life and Letters. In 1863, she wrote that she was “a total disbeliever in the
distinctive tenets of the technically called orthodox system of divinity” but swore not
to attend any stage performance for ten years, lest anyone believe that she had left
the church in search of amusement (Jacobi, Life and Letters, 58).
12. Mary Putnam Jacobi, “Fragment at the thought of her twelfth birthday,” filed
with Correspondence, Mary Putnam Jacobi Collection, Jacobi Papers, folder 5,
Schlesinger Library, Radcliffe College.
13. Mary Putnam Jacobi, “Foreword to the Family,” Mary Putnam Jacobi Collec-
tion, Jacobi Papers, a-26, folder 3, SL.
14. See her father’s letter about the “repulsive pursuit” of medical science (Jacobi,
Life and Letters, 70) and also his letters urging her to delay her medical studies and
to return home from Paris (Jacobi, Correspondence, 1871, folder 8). George Putnam
did become reconciled to his daughter’s medical career.
15. See Jacobi, Life and Letters, 110, Feb. 1, 1867. As a mother, Mary Putnam
260
Jacobi wrote to her daughter in terms that recalled those she had used toward her
father. During a serious illness, Putnam Jacobi wrote a letter to be read by her daugh-
ter after Mary’s death; she urged her daughter “always to seek to know the most that
can be known, so as to be able to live the largest life” (Jacobi, Correspondence, letter
to Marjorie Jacobi, July 3, 1889, Mary Putnam Jacobi Collection, Jacobi Papers,
folder 14, Schlesinger Library, Radcliffe College).
16. Jacobi’s letter to Dr. J. V. Ingham, 1900, autograph case, CPP, details her pro-
fessional memberships.
17. Mary Putnam Jacobi, “Woman in Medicine,” in Woman’s Work in America,
ed. Annie Nathan Meyer (New York: Holt, 1891), 139–205. Full bibliographies of
Mary Putnam Jacobi’s work can be found in Life and Letters and in Pathfinder.
18. Mary Putnam Jacobi, M.D., and Victoria White, M.D., On the Use of the Cold
Pack Followed by Massage in the Treatment of Anaemia (New York: Putnam’s Sons,
1880); and Mary Putnam Jacobi, Essays on Hysteria, Brain Tumor and Some Other
Causes of Nervous Disease (New York: Putnam’s Sons, 1888).
19. See, for example, Elizabeth Blackwell’s collection Essays in Medical Sociology
(New York: Arno Press, 1972; original publication, 1902); and her Laws of Life: With
Special Reference to the Physical Education of Girls (New York: Garland, 1986; origi-
nal publication, 1852).
20. See the list of publications by members of the Woman’s Medical College of
Pennsylvania Alumnae Association in Clara Marshall, The Woman’s Medical College
of Pennsylvania: An Historical Outline (Philadelphia: P. Blakiston, 1897), 89–142.
21. Mary Putnam Jacobi, “Urethral Irritation,” Proceedings of the Philadelphia
County Medical Society 13 (1892): 450–62; quotation from Henry, 457; quotation
from Tyson, 458; quotation from Roberts, 460.
22. Jacobi, Correspondence, 1861, folder 7.
23. Jacobi, Life and Letters, 266.
24. Mary Putnam, “Theorae ad Lienis officium,” Thesis Medicinae Collegii Foe-
minis Pennsylvaniae Facultati submissa ad gradem obtinendum Medicinae Doctoris,
Maria C. Putname scripta, New York, 1864.
25. WMC, Faculty Minutes, Feb. 26, 1864, MCP Collection, ASCWM.
26. For a full account of the controversy concerning Mary Putnam’s status at the
Woman’s Medical College, see Carol Gartner, “Fussell’s Folly: Academic Standards
and the Case of Mary Putnam Jacobi,” Academic Medicine 71, no. 5 (May 1996):
470–77.
27. Jacobi, “Woman in Medicine,” 161–62.
28. Jacobi, “Woman in Medicine,” 163.
29. Jacobi, letter to her mother, June 1864, in Jacobi, Life and Letters, 275.
31. Some of the New Orleans Sunday Times columns are collected in the Mary
Putnam Jacobi Collection, Jacobi Papers, folder 28, SL; they are signed “Mary Israel”
and begin as sketches written while Putnam was tutoring in New Orleans. The
sketches began to be published in October 1866 (Jacobi, Life and Letters, 106); they
were “cut back” early in 1867 and came to an end sometime before May 1867 (Jacobi,
Life and Letters, 110, 133). The essays in the Medical Record, signed “P. C. M.,” were
written from 1867 to 1870 and are reprinted in Jacobi, Pathfinder, 1–171. The letters
261
to the New York Evening Post began as compilations from French newspapers, for
which she was paid ten dollars a week, and they developed into notes on “gossip.”
Putnam began writing them in December 1866; they were cut back in the summer
of 1867 and resumed as weekly columns in September 1867, although the editor
became dissatisfied with them in November, and they seem to have been discon-
tinued soon after (Jacobi, Life and Letters, 107, 112, 147, 153). In October 1867, the
Philadelphia Reporter also began to carry her letters (Jacobi, Life and Letters, 150).
I have not made a complete search for this journalism.
32. For the Medical Record correspondence, see Joy Harvey, “La Visite: Mary
Putnam Jacobi and the Paris Medical Clinics,” in French Medical Culture in the Nine-
teenth Century, ed. Ann La Berge and Mordechai Feingold, Wellcome Institute Se-
ries in the History of Medicine (Amsterdam and Atlanta, Ga.: Clio Medica 25, 1994),
350–71. The correspondence is also discussed in John Harley Warner, Against the
Spirit of System: The French Impulse in Nineteenth-Century American Medicine
(Princeton, N.J.: Princeton University Press, 1998), 322–29. Warner concludes that
“it is quite possible that Putnam, during her time abroad, wrote more on Paris than
any other nineteenth-century American physician—in private letters, in professional
journals, in popular periodicals, and in newspapers,” but that Putnam, coming to
Paris after French empiricism had been disseminated to the United States, did not
experience Parisian medicine as deeply at odds with American scientific medicine
(328).
33. Jacobi, Life and Letters, 134–37.
36. “Imagination and Language,” originally published in Putnam’s Monthly, Mar.
1868; “A Study of Still-Life, Paris,” from Putnam’s Monthly, Dec. 1868; “A Sermon
at Notre-Dame,” from Putnam’s Monthly, Dec. 1868 and Feb. 1869; “A Martyr to
Science,” from Putnam’s Monthly, Aug. 1869; Concerning Charlotte, from Putnam’s
Monthly, Jan., Feb., and Mar. 1870; and “Some of the French Leaders,” from Scrib-
ner’s Monthly, Aug. 1871, are reprinted with the early stories “Found and Lost” and
“Hair Chains” in Mary Putnam Jacobi, Stories and Sketches (New York: Putnam’s
Sons, 1907). All citations to these stories pertain to Stories and Sketches. Her letter to
her family of Sept. 4, 1871, was reprinted in Putnam’s Monthly, Nov. 1870; it is included
in Jacobi, Life and Letters, 255–69. She also wrote “The Clubs of Paris,” Scribner’s
Monthly 3 (Nov. 1871): 105–8, which is not included in Stories and Sketches.
41. For an account of Mary Putnam Jacobi’s political activity and relationship to
the Réclus family, see Joy Harvey, “Medicine and Politics: Dr. Mary Putnam Jacobi
and the Paris Commune,” Dialectical Anthropology 15 (1990): 107–17.
44. Nancy Cervetti, “S. Weir Mitchell: Literature and Medicine,” unpublished
talk, Wood Institute for the History of Medicine, Mar. 1997, CPP.
262
45. See the use of woorara in Mary Putnam Jacobi, “Pathogeny of Infantile Paraly-
sis,” a paper originally read before the New York County Medical Society, Dec. 22,
1873, first published in the American Journal of Obstetrics 8 (1874): 1–24, and in-
cluded in Jacobi, Pathfinder, 240–83; and Mary Putnam Jacobi, “The Indication for
Quinine in Pneumonia,” first published in the New York Medical Journal, 1887, and
included in Jacobi, Pathfinder, 419–45.
47. Jacobi, Stories and Sketches, 223.
51. Mary Putnam Jacobi, “Inaugural Address at the Opening of the Woman’s Med-
ical College of the New York Infirmary, October 1, 1880,” in Jacobi, Pathfinder, 347.
52. Mary Putnam Jacobi, “Modern Female Invalidism,” in Jacobi, Pathfinder, 482.
53. Charles Reade, The Woman-Hater (Paris and Boston: Grolier Society, n.d.).
The Woman-Hater was originally published in Blackwood’s Magazine from June 1876
to June 1877 and then issued in three volumes in June 1877. See the interesting
discussion of the relation between this novel and British physician Sophia Jex-Blake
in Frederick Wegener, “‘A Line of Her Own’: Henry James’s ‘Sturdy Little Doctress’
and the Medical Woman as Literary Type in Gilded-Age America,” Texas Studies in
Language and Literature 39, no. 2 (summer 1997): 139–80.
54. Harvey, “La Visite.”
55. Jacobi, Pathfinder, 34.
56. Jacobi, Pathfinder, 46, 57.
57. Jacobi, Pathfinder, 62–67, 96–97, 114.
59. Margaret Richardson, “A Disquisition on Phthisis Pulmonalis,” respectfully
gural Thesis for the Degree of the Doctorate in Medicine, By Margaret Richardson
of Pennsylvania, Period of Study, three years, Preceptor, J. S. Longshore, M.D., Phil-
adelphia, December 30th, 1852, 16–17, ASCWM. See the discussion of Richardson’s
thesis in chapter 4 of this book.
60. John W. Sale, “An Essay on Haemoptysis” For the Degree of Doctor of Medi-
cine in the University of Pennsylvania, by John W. Sale, of Bedford County, State of
Virginia, Residence in the City No. 13th Filbert St. Preceptor R. A. Sale, M.D., Dura-
tion of Studies 3 years, Presented on the 15th of Jany, 1850, 5–7, PA.
61. Steven Peitzman, A New and Untried Course: Woman’s Medical College and
Medical College of Pennsylvania (New Brunswick, N.J.: Rutgers University Press,
2000), chap. 4.
63. Barbara Stafford, Body Criticism: Imaging the Unseen in Enlightenment Art
and Medicine (Cambridge, Mass.: MIT Press, 1991).
64. Sir Walter Scott, Waverly (New York: Penguin, 1972; original publication,
1814), 175.
65. Ralph Waldo Emerson, “Nature,” in Emerson: Essays, First and Second Series,
ed. Douglas Crane (New York: Vintage, 1990), 313.
263

68. Jacobi, Pathfinder, 114–33, 28–31, 73–75, 137–43.
69. M. A. K. Halliday and J. R. Martin, Writing Science: Literacy and Discursive
Power (Pittsburgh: University of Pittsburgh Press), 13–15.
72. Jacobi, Pathfinder, 22–24, 41–44, 65–72, 143–70.
73. Ludmilla Jordanova, Sexual Visions: Images of Gender in Science and Medi-
cine between the Eighteenth and Twentieth Centuries (New York: Harvester, 1989),
87–110.
75. Jacobi, Correspondence, 1871.
76. Putnam to her mother, in Jacobi, Life and Letters, 271.
78. Jacobi, “The Clubs of Paris,” 105–8.
79. See Jacobi, Stories and Sketches, 390–443.
81. Gilder’s remarks were made at a memorial meeting, Jan. 4, 1907. Addresses
were also given by William Osler, Dr. Elizabeth Cushier, Prof. Felix Adler, Mrs. Flor-
ence Kelley, Dr. Charles Dana, Mr. Richard Watson Gilder, and Dr. Annie S. Daniel.
An invitation to the meeting is included in Jacobi, Correspondence, folder 20. The
address itself was published as Richard Watson Gilder, “Address,” in In Memory of
Mary Putnam Jacobi (New York: Academy of Medicine, 1907), 43–56, quotation on
53. The comments in The Nation are reported in Jacobi, Life and Letters, 294.
82. Jacobi, “Clubs of Paris,” 107.
83. Jacobi, “Clubs of Paris,” 107.
85. For summaries of Putnam Jacobi’s early presentations to the Pathological Soci-
ety, see Mary Putnam Jacobi: “Anomalous Malformation of the Heart,” 111; “Intesti-
nal Obstruction,” 208; “Thrombosis of Ovarian Veins,” 215; “Scarlatinous Nephritis,”
354 (all in Medical Record 7 [1872]); and “Phenomena Attending Section of the Right
Restiform Body,” 17; “A Case of Malignant Icterus,” 65; and “Ovarian Tumor,” 342
(all in Medical Record 8 [1873]).
For Mary Putnam’s entrance into professional societies, I have drawn on the ac-
count in “Member of Medical Societies,” in Jacobi, Pathfinder (xxviii–xxx), and the list
included in her letter to Dr. J. V. Ingham, 1900, autograph case, CPP. The Pathfinder
account gives two dates for Mary Putnam’s admission to the New York County Medi-
cal Society, locating it on November 27, 1871, and in 1873. The first date is correct.
86. Jacobi, “Some Details,” Pathfinder, 177–78.
87. I am deeply indebted to Russell Viner for his paper “Radical Medicine in Ante-
Bellum New York City: Abraham Jacobi and German Social Medicine in America,”
Fall 1996 Workshop Series of the Department of History and Sociology of Science
at the University of Pennsylvania, Oct. 7, 1996. The standard published contempo-
rary source on Mary Putnam Jacobi’s relation with Abraham Jacobi is Joy Harvey,
“Clanging Eagles: The Marriage and Collaboration between Two Nineteenth-
264
Century Physicians, Mary Putnam Jacobi and Abraham Jacobi,” in Creative Couples
in the Sciences, ed. Helena Pycior, Nancy Slack, and Pnina Abir-am (New Brunswick,
N.J.: Rutgers University Press, 1995), 185–95.
88. Rhoda Truax, The Doctors Jacobi (Boston: Little, Brown, 1952).
89. See the undated letter from Abraham Jacobi, asking Mary Putnam Jacobi, ap-
parently living elsewhere after a quarrel, to return home (Jacobi, Correspondence,
folder 21). Harvey dates this letter in spring 1883.
90. Letter from Mary Putnam to her mother, Jan. 25, 1868, in Jacobi, Life and
Letters, 168.
91. Gilder, “Address,” 53.
92. “Croup and Diphtheria,” Medical Record 12 (1876): 397, was signed “M. P.
Jacobi”; “Note on the Cause of Sudden Death during the Operation of Thoracente-
sis,” letter to the editor, Medical Record 16 (1879): 139, was signed “M. Putnam-
Jacobi”; “Case of Facial and Palatine Paralysis and Loss of Equilibrium Produced by
a Fall on the Head,” Independent Practitioner 2 (1881): 69, was signed “M. Putnam
Jacobi, M.D.” Her most common signature was “Mary Putnam Jacobi, M.D.”; this
was her signature for both The Question of Rest for Women during Menstruation and
the Essays on Hysteria. Many of these signatures conceal Jacobi’s gender; they also
alternate between hyphenating her paternal name with her husband’s or keeping it
as a middle name.
Some of Mary Putnam Jacobi’s many drafts of her name survived; the memorial
tablet in her honor at the Woman’s Medical College of Pennsylvania is inscribed to
“Mary Putnam Jacobi,” but the account of unveiling the tablet records her name as
“Mary Putnam-Jacobi” (WMC, Alumnae Association, “Addresses at the Unveiling of
a Memorial Tablet in Honor of Mary Putnam-Jacobi,” in WMC, Transactions of the
Thirty-second Annual Meeting of the Alumnae Association of the Woman’s Medical
College of Pennsylvania, May 23–24, 1907 [Philadelphia: Published by the associa-
tion, 1907], 56–71, MCP Collection, ASCWM). The Life and Letters and Pathfinder
volumes both speak of her as Mary Putnam Jacobi. In this book, I have used the most
common forms of her name, referring to her as Mary Putnam before her marriage
and as Mary Putnam Jacobi after her marriage, using “Putnam Jacobi” as the
surname.
93. The first edition of this work is a fifty-page pamphlet: Abraham Jacobi, Infant
Diet, a Paper Read before the Public Health Association of New York, by A. Jacobi,
M.D. (New York: Putnam’s Sons, 1873). It was reissued in 1874 as A. Jacobi, Infant
Diet, Revised, Enlarged, and Adapted to Popular Use by Mary Putnam Jacobi, M.D.
(New York: Putnam’s Sons), 119 pp.; it was part of the Putnam’s Handy Book Series
of popular educational materials.
94. A. Jacobi, Infant Diet, rev. ed., iii.
95. A. Jacobi, Infant Diet, rev. ed., v.
96. A. Jacobi, Infant Diet, rev. ed., iv.
97. A. Jacobi, Infant Diet, rev. ed., iv.
98. Mary Putnam Jacobi, “Reply to Prof. Munsterberg on American Women’s Ed-
ucation,” typescript, Mary Putman Jacobi Collection, Jacobi Papers, Writings, 1873,
folder 30, 3, Schlesinger Library, Radcliffe College.
99. Jacobi, “Reply to Prof. Munsterberg,” 14.
265
100. Jacobi, “Reply to Prof. Munsterberg,” 14.

101. Edward H. Clarke, Sex in Ediucation: Or, A Fair Chance for Girls (Boston:
Osgood, 1873).
102. Vern Bullough and Martha Voght, “Women, Menstruation, and Nineteenth-
Century Medicine,” Bulletin of the History of Medicine 47 (1973): 66–82. See also
Thomas Laqueur, Making Sex: Body and Gender from the Greeks to Freud (Cam-
bridge, Mass.: Harvard University Press, 1990), 220–24. Laqueur locates Putnam
Jacobi’s innovation in the assimilation of reproduction to nutrition but does not un-
derstand that Putnam Jacobi saw nutrition as the broad process, involving both
nerves and blood, both food and stimulation. Although Laqueur’s critique places Put-
nam Jacobi’s essay within the millennial controversy between one-sex and two-sex
theories, it does not place the essay within specific nineteenth-century understand-
ings of nutrition, and it ignores the performative aspects of the essay, including its
use of survey information.
103. Jacobi, Pathfinder, xxvii.
104. C. Alice Baker reported this to Mary Putnam Jacobi in a letter to her, Nov.
7, 1874, Mary Putnam Jacobi Collection, Jacobi Papers, Baker correspondence,
Schlesinger Library, Radcliffe College.
105. Baker, letter to Putnam Jacobi, Nov. 7, 1874. Baker refers to an essay of Ja-
cobi’s in “Miss Brockett’s book,” which does not appear in any of the Putnam Jacobi
bibliographies.
106. Agnes C. Vietor, ed., A Woman’s Quest: The Life of Marie Zakrzewska, M.D.
(New York: Appleton, 1924), 67.
107. This event was reported in the London Echo (Monday, Aug. 29, 1870, 4); the
prizewinner’s name is given as “Margaret Webster.” In a cognate account in the New
Republic (June 25, 1870; WMC, College Scrapbooks, #3, Jan. 1870–Aug. 1871, 10,
ASCWM), the name of the sponsoring journal is given as the Medical Gazette. No
journal by that name was published in Philadelphia; the New York Medical Gazette
ran a contest for the largest number of publishable clinical accounts but did not pub-
lish during this period. I am grateful to Sally Mitchell for the original Echo account.
108. Jacobi, The Question of Rest, 78.
109. Laqueur, Making Sex, 221–23.
110. Laqueur, Making Sex, 223–24.
113. D. Armstrong, Political Anatomy of the Body: Medical Knowledge in Britain
in the Twentieth Century (Cambridge: Cambridge University Press, 1983), 51.
116. Catherine Beecher, Letters to the People on Health and Happiness (New
York: Harper and Row, 1855); see also the useful discussion of Beecher, Weir Mitch-
ell, and Elizabeth Blackwell in Ann Douglas Wood’s “‘The Fashionable Diseases’:
Women’s Complaints and Their Treatment in Nineteenth-Century America,” Journal
of Interdisciplinary History 4 (1973): 25–52.
117. Beecher, Letters to the People, 124.
118. Elizabeth Blackwell, “The Influence of Women in the Profession of Medi-
266
cine,” in Essays in Medical Sociology, vol. 2 (New York: Arno Press, 1972; original
publication, 1902), 20.
119. For an extended comparison of Putnam Jacobi and Elizabeth Blackwell, see
Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians in
American Medicine (New York: Oxford University Press), 184–202.
121. See Mary Putnam Jacobi, “Nitrite of Amyl and Belladonna in Dysmenor-
rhoea,” Medical Record 10 (1875): 11; and Mary Putnam Jacobi, “Remarks upon the
Action of Nitrate of Silver on Epithelial and Gland Cells,” Transactions of the New York
State Medical Society (1875): 251, reprinted in Jacobi, Pathfinder, 284–94; Mary Put-
nam Jacobi, “Provisional Report on the Effect of Quinine upon the Cerebral Circula-
tion,” Archives of Medicine 1 (1879): 33. The bibliography printed in Pathfinder also
lists “The Treatment of Hydrophobia by Woorara,” in the Transactions of the New York
State Medical Society (1877): 23, an essay I have not been able to locate or confirm.
For other essays written during the 1870s, see, for example, Mary Putnam Jacobi,
“Curious Congenital Deformities of Upper and Lower Extremities,” Medical Record
12 (1878): 115; and Mary Putnam Jacobi, “Acute Fatty Degeneration of the New-
born,” American Journal of Obstetrics 2 (1878): 499, reprinted in Jacobi, Pathfinder,
311–25. For presentations at the Pathological Society, see Mary Putnam Jacobi, “Pu-
erperal Fever, Infection from Ovary through Retroperitoneal Glands,” Medical Rec-
ord 11 (1876): 307 (not 387, as in Jacobi, Pathfinder bibliography); or Mary Putnam
Jacobi, “Malignant Icterus with Great Enlargement of the Liver,” Transactions of the
New York State Pathological Society 3 (1879): 50.
122. For sphygmographic investigations see Mary Putnam Jacobi, “Sphygmo-
graphic Experiments upon a Human Brain Exposed by an Opening in the Cranium,”
American Journal of the Medical Sciences 76 (1878): 10–21, reprinted in Jacobi, Path-
finder, 299–310; and Mary Putnam Jacobi, “Contribution to Sphygmography: The
Influence of Pain on the Pulse Trace,” Archives of Medicine 1 (1879): 33–35, re-
printed in Jacobi, Pathfinder, 326–28.
123. “Studies in Endometritis” was published in successive numbers of the Ameri-
can Journal of Obstetrics 18 (1885): 36–50, 113–28, 262–83, 519–37, 596–606. A
series of related articles continues in that same issue of the journal as “Morbid Varia-
tions in the Greater or Parturient Cycle, Subinvolution and Chronic Metritis (Studies
in Endometritis),” 802–30; and “Menstrual Subinvolution or Metritis of the Non-
parturient Uterus (Studies in Endometritis),” 915–25. And in a subsequent issue of
the journal, the series continues with “The Ovarian Complication of Endometritis
(Studies in Endometritis),” American Journal of Obstetrics 19 (1886): 352–67; “Theo-
ries of Menstruation: New Theory (Studies in Menstruation),” American Journal of
Obstetrics 18 (1885): 376.
Essays on Hysteria, Brain-Tumor and Some Other Cases of Nervous Disease con-
tains a number of essays not reprinted elsewhere, although “A Case of Probable Tu-
mor of the Pons” is reprinted in Jacobi, Pathfinder, 446–57. For Putnam Jacobi’s
earliest work in nervous diseases, see her publication with Victoria White, On the Use
of the Cold Pack Followed by Massage in the Treatment of Anaemia.
124. Silas Weir Mitchell, Fat and Blood: And How to Make Them, 2d ed. (Phila-
delphia: Lippincott, 1878; original publication, 1877); the library of the College of
267
Physicians of Philadelphia shows eight editions. Charlotte Perkins Gilman, “The Yel-
low Wall-Paper,” in The Yellow Wall-Paper, ed. E. Hedges, rev. 2d ed. (Old Westbury,
Conn.: Feminist Press, 1996; short story originally published 1892 in New England
Magazine), 9–36.
125. Jacobi and White, On the Use of the Cold Pack, 4.
126. Jacobi and White, On the Use of the Cold Pack, 46.
127. Mary Putnam Jacobi, “Some Considerations on Hysteria,” in Jacobi, Essays
on Hysteria, 1.
128. See, for example, Mitchell’s advice that the physician “seize the proper occa-
sions to direct the thoughts of his patients to the lapse from duties to others, and to
the selfishness which a life of invalidism is apt to bring about. Such moral medication
belongs to the higher sphere of the doctor’s duties, and if he means to cure his patient
permanently, he cannot afford to neglect them” (Fat and Blood, 46). Putnam Jacobi
sent Weir Mitchell a copy of her hysteria book; he wrote a letter praising what he
had read, confessing that he envied Putnam Jacobi her “strong logical use of facts in
theory. . . . I reason with difficulty on these complex questions with which your mind
seems to play” (Mitchell, undated letter in Jacobi, Correspondence, 1901–2, folder 17).
129. Jacobi, “Some Considerations on Hysteria,” 12.
132. Jacobi, “Some Considerations on Hysteria,” 64–65.
133. WMC, Alumnae Association, “Addresses at the Unveiling of a Memorial Tab-
let in Honor of Mary Putnam-Jacobi,” 56–71, 66.
134. Charlotte Perkins Gilman, The Diaries of Charlotte Perkins Gilman, vol. 2:
1890–1935, ed. Denise D. Knight (Charlottesville: University Press of Virginia,
1994), 819–23. See also Gilman’s account in The Living of Charlotte Perkins Gilman:
An Autobiography (New York: Appleton-Century, 1935), where she writes that “the
distinctive feature of her method was to set that inert brain to work under her direct
suggestion and supervision, on small, irrelevant tasks; this to re-establish the capacity
for action, without demanding any effort from me. We began with kindergarten
blocks, just building things, for slowly increasing periods of application, but before
she was through with me I was reading, still at her desk and under her direction,
Wilson on The Cell” (291).
138. Truax, The Doctors Jacobi, 202–9; Jacobi, Pathfinder, 349.
139. See, besides “Studies in Endometritis,” previously noted, Mary Putnam Ja-
cobi: “The Nature and Dangers of Intra-uterine Medication,” Medical Record 33
(1888): 23; “Intra-Uterine Therapeutics,” American Journal of Obstetrics 22 (1889):
449; “Limitations and Dangers of Intra-Uterine Medication,” American Journal of
Obstetrics 22 (1889): 598, 697; “The Use of Electricity in Gynaecology,” WMC, Re-
port of the Proceedings of the Fourteenth Annual Meeting of the Alumnae Association
of the Woman’s Medical College of Pennsylvania, Mar. 15, 1889 (Philadelphia: Rod-
gers Printing Co, 1889), 60, MCP Collection, ASCWM.
140. Mary Putnam Jacobi: “A Case of Trephining of Sternum for Osteomyelitis,”
268
American Journal of Obstetrics 14 (1881): 981; “Salpingo-oophorectomy,” New York

Medical Journal 29 (1884): 673; “Cystic Ovaries; Battey’s Operation,” Medical Record
25 (1884): 705. For further examples of surgical cases see Mary Putnam Jacobi: “Aspi-
ration of Dermoid Cysts Followed by Inflammation,” American Journal of Obstetrics
16 (1883): 1160–70; and Mary Putnam Jacobi, “Case of Uterine Fibroid Treated by
Apostoli’s Method: Enucleation of the Tumor,” American Journal of Obstetrics 21
(1888): 806.
141. Jacobi, Essays on Hysteria, 178.
142. Jacobi, “Studies in Endometritis,” 283.
143. Jacobi, Essays on Hysteria, 178.
144. Jacobi, “Studies on Endometritis,” 37.
145. Illustrations appear in Jacobi, “Studies in Endometritis” on 126, 262–63,
266–67, 269, 811–16, and 923. Other significant illustrations occur in Mary Putnam
Jacobi: “Case of Absent Uterus: With Considerations of the Significance of the Her-
maphrodism,” American Journal of Obstetrics 32, no. 4 (Oct. 1895): 512; and “Re-
marks upon Empyema,” Medical News 56 (1890): 120–21, 172–73.
151. Judith Butler, Gender Trouble: Feminism and the Subversion of Identity
(New York: Routledge, 1990), 24–25.
152. But see Regina Morantz-Sanchez, “Making It in a Man’s World: The Late-
Nineteenth-Century Surgical Career of Mary Amanda Dixon Jones,” Bulletin of the
History of Medicine 69 (1995): 542–68.
160. Jacobi, Pathfinder, 480. The specific essay is “Modern Female Invalidism,”
unpublished before its inclusion in Pathfinder, 478–82.
162. Jacobi, Pathfinder, 394, 397.
CHAPTER 7. FORBIDDEN SIGHTS: WOMEN AND THE VISUAL

ECONOMY OF MEDICINE
1. This account is drawn from Pennsylvania Hospital, Minute Book of the Board
of Managers, Oct.–Dec. 1869, R11D12, HLPH; and from WMC, College Scrap-
269
books, MCP-C7, Acc. #133, ASCWM, which is a collection of many (often unidenti-
fied) press clippings on the event. I have also consulted the accounts given, usually
many years later, by students who were present at the jeering incident: Anna
Broomall and Eliza Wood-Armitage, all included in the WMC Deceased Alumnae
Files, ASCWM; Sarah Hibbard, manuscript draft of lectures and sermons, Manu-
scripts, MS 54, Acc. #189, ASCWM; and the recollections by Evelyn Keller, in her
reply to a toast at the 1906 alumnae banquet, “Report of the Entertainment Commit-
tee,” in WMC, Alumnae Association, Transactions of the Thirty-first Annual Meeting
of the Alumnae Association of the Woman’s Medical College of Pennsylvania, May
24–25, 1906 (Philadelphia: Published by the association, 1906), 36, MCP Collection,
ASCWM. The medical press covered these incidents; there were regular articles in
the Philadelphia Medical and Surgical Reporter, the New York Medical Gazette, and
the Boston Medical and Surgical Journal, and accounts were included in the standard
histories of the Pennsylvania Hospital: J. Forsyth Meigs, M.D., A History of the First
Quarter of the Second Century of the Pennsylvania Hospital, read before the board
of managers at their stated meeting held 9th mo 25th, 1876 (Philadelphia: Board
of Managers, 1877), CPP; Thomas Morton, M.D., The History of the Pennsylvania
Hospital, 1751–1895 (Philadelphia: Times Printing House, 1897); and Francis R.
Packard, M.D., “The Pennsylvania Hospital,” in Founders’ Week Memorial Volume,
ed. Frederick P. Penry, A.M., M.D., Published by the City of Philadelphia in Com-
memoration of the Two Hundred and Twenty-fifth Anniversary of Its Founding (Phil-
adelphia, 1909), 595–612. I am grateful to Steven Peitzman for showing me the ac-
count of this incident in his A New and Untried Course: Woman’s Medical College
and Medical College of Pennsylvania ((New Brunswick, N.J.: Rutgers University Press,
2000). And Michael Sappol’s A Traffic in Dead Bodies: Anatomy and Embodied Social
Identity in Nineteenth-Century America (Princeton, N.J.: Princeton University Press,
2001), invaluable throughout this project, has been especially useful in this chapter.
2. Packard, “The Pennsylvania Hospital,” 602.
System (New York: Basic Books, 1987), 50–51.
4. Leo J. O’Hara, An Emerging Profession: Philadelphia Doctors, 1860–1890
(New York: Garland, 1989), 85.
5. Meigs, A History of the First Quarter, 23; Morton, History of the Pennsylvania
Hospital, 360.
6. Meigs, A History of the First Quarter, 25.
7. Meigs, A History of the First Quarter, 27.
8. Numbers vary in different accounts. Anna Broomall’s recollection, retold at her
seventy-ninth birthday in 1926, was that “there were twenty of us” (Anna Broomall,
Deceased Alumnae Files, newspaper clipping). At the memorial held for her in 1932
by the Delaware County Historical Society, Dr. Mary Griscom spoke of the “valiant
nine” women medical students who were mobbed at the clinical lectures at Pennsyl-
vania Hospital (Mary Griscom, M.D., “Memorial Meeting for Dr. Anna E. Broomall,”
Apr. 4, 1932, in Anna E. Broomall, Deceased Alumnae Files). A clipping in the Eliza
Wood-Armitage scrapbook puts the number at thirty-five (“Our Philadelphia Corre-
spondence,” Nov. 7, 1869, in Eliza Wood-Armitage, Scrapbook, 1, Deceased Alum-
nae Files, ASCWM). Evelyn Keller, replying to a toast at the 1906 alumnae banquet,
270
said that “thirty-five of us” attended the lecture (WMC, Alumnae Association, Trans-
actions of the Thirty-first Annual Meeting, 36). A resolution by the Pennsylvania Hos-
pital Board of Managers, Nov. 13, 1869, speaks of thirty students (Pennsylvania Hos-
pital, Minute Book of the Board of Managers, R11D12, HLPH). The New York
Citizen and Round Table, quoted in a Philadelphia Press article in the Wood-
Armitage scrapbook, speaks anxiously of “twenty-five Wild Women, determined to
witness the carving and cutting of the masculine form divine” (Wood-Armitage,
Scrapbook, 7). The New York World, surprised to see such goings on in “Philadel-
phia, the dullest village in America,” gives the number as thirty-four, attended by
a “senior female physician” (Wood-Armitage, Scrapbook, 8). The New York Medi-
cal Gazette, “The Pennsylvania Hospital Scandal,” 3 (Nov. 20, 1869): 294, spoke of
twenty-seven women students.
9. Again, accounts vary. Corson’s note is recounted in Anna Broomall’s birthday
recollection (how the fortunes of that family were linked to those of women physi-
cians!), which speaks of “pandemonium” at the women’s entrance, with students
standing on their seats, hooting, and throwing spitballs (Broomall, Deceased Alum-
nae Files). Evelyn Keller, writing in 1906, describes an entry “amidst jeers and groan-
ings, whistling and stamping of feet” (WMC, Alumnae Association, Transactions of
the Thirty-first Annual Meeting, 36). The Wood-Armitage clipping, “Our Philadel-
phia Correspondence,” speaks of “a tumultuous uproar” (Wood-Armitage, Scrap-
book, 1). The board of managers’ resolution refers to “hissing” and “other conduct
unbecoming in any well-regulated institution” (Morton, History of the Pennsylvania
Hospital, 365). Some male medical students claimed that their stamping, laughter,
applause, and hissing were normal occurrences at the lectures; a letter signed “Jeffer-
son” in the Evening Star claims that the women students “were treated the same as
the male students, who often stamp and hoot at each other, and we propose that the
ladies shall enjoy the same rights that we ourselves enjoy.” Another letter to the Eve-
ning Star, signed “Aggrieved Male Student,” suggested that it was the Eclectics and
irregular students, rather than those from the University of Pennsylvania or Jefferson,
who had been abusive (both letters in Wood-Armitage, Scrapbook, 9–10).
10. Anna Broomall, in a newspaper account of a celebration of her seventy-ninth
birthday, gives the names of the managers as Dilwyn Parrish, a Hicksite, and William
Biddle (Anna Broomall, Deceased Alumnae Files). All contemporaneous accounts
agree on Biddle’s impressive presence; the second manager, however, is usually iden-
tified as A. J. Derbyshire (see “Our Philadelphia Correspondence,” Wood-Armitage,
Scrapbook, 1). Other newspaper accounts quoting from this article identify the
source of “Our Philadelphia Correspondence” as the Anti-Slavery Standard.
11. Anna Broomall, in the newspaper account of a celebration of her seventy-ninth
birthday, gave the names of the lecturers as Dr. Hutchinson (medicine) and Dr. Levis
(surgery). But all other contemporaneous accounts agreed that Hunt and Da Costa
were the lecturers (see, for example, “Our Philadelphia Correspondence,” Nov. 7,
1869, in the Wood-Armitage Scrapbook, 1); no Levis was on medical or surgical staff
of the Pennsylvania Hospital in 1869 (Meigs, A History of the First Quarter, 95).
A Dr. Levis did lecture on surgery at the Blockley (WMC, College Scrapbooks, A,
1816–48, 27).
12. Quoted in Robert M. Kaiser, Sandra L. Chaff, and Steven J. Peitzman, “A
271
Philadelphia Medical Student of the 1890’s: The Diary of Mary Theodora McGav-
ran,” Pennsylvania Magazine of History and Biography 108, no. 2 (Apr. 1984): 217–
36, quotation on 227.
13. WMC, College Scrapbooks, A, 1816–48, 11.
14. “Women Medical Students,” New York Tribune, Nov. 13, 1869, clipping pasted
in a bound volume (1866–79) of the Woman’s Medical College Annual Announce-
ments, MCP Collection, ASCWM.
15. R. C., letter to the New Republic, in WMC, College Scrapbooks, A, 1816–48, 31.
16. In A. Broomall’s birthday recollection, she says, “We were hustled and jostled
into the hall. Dilwyn Parrish had sent men to close the gates against the boys. They
burst the barriers open and knocked him over in the fracas. He raised his trembling
hands in protest, crying: ‘The Pennsylvania Hospital will not have this!’ Borne along
as on the crest of a wave, we found ourselves in 8th street and went twenty different
ways, still pursued by taunts and jeers” (A. Broomall, Deceased Alumnae Files). (It
is very unlikely that Parrish was there; see n. 10 above.) Griscom’s memorial speech
has the managers “hustled and pushed” by students, locking the women in a safe
room, and sending them home a few at a time (Griscom, “Memorial Meeting”). The
writer of “Our Philadelphia Correspondence” says that the male students blocked
the walk leading through the yard, so that women students were forced into the car-
riage way. When they reached the street, they were followed, “greatly to their annoy-
ance,” by male students “uttering various uncouth noises and indecent comments,
and making other manifestations peculiar to this class of ‘gentlemen.’” Another ar-
ticle in the Wood-Armitage scrapbook describes the male students forming “a line
on each side of the walk, intending the ladies to run the gauntlet of their stares, and
intending a salutation also.” When the women left by the road rather than the foot-
path, “a mock procession was formed, and the insults kept up for some distance”
(Wood-Armitage, Scrapbook, 3). A similar account appears in the Ledger for Novem-
ber 8 (WMC, College Scrapbooks, A, 1816–48, 17a), which describes the twenty-
seven students passing “between the double lines of the male students, whilst the
later saluted them with taunts and jeers, mock applause, and real hisses.” The New
York Medical Gazette, in “The Pennsylvania Hospital Scandal,” does not mention any
harassment inside the hall but describes “the sidewalk lined on either side by the
male students who had been in attendance, and who undertook to express their dis-
approbation of the course adopted by the hospital authorities, by forcing a handful
of defenseless women to run the gauntlet of their jeers. To escape this peril, the
terrified victims took to the roadway, whereupon their persecutors formed a mock
procession and followed them for some distance with hisses and jibes” (294).
17. Elizabeth Keller, in reply to a toast to the “Pathfinders,” quoted in H. Frances
Bartlett, “Report of the Entertainment Committee,” in WMC, Alumnae Association,
Transactions of the Thirty-first Annual Meeting, 1906, 36.
18. The clipping scrapbook of Eliza Wood-Armitage includes “Our Philadelphia
Correspondence,” from the Nov. 7, 1869, Anti-Slavery Standard (Wood-Armitage,
Scrapbook). The article observes that during the Civil War, medical students, “espe-
cially those who were born in the baleful shadow of slavery,” were known for their
“ribaldry and jest, their violence, indecency and scurrility on manifold occasions” (1).
Another clipping in her file, from the Philadelphia Sunday Transcript (Nov. 14,
272
1869), speaks of “a time when ‘the students’ used to exercise their loaded canes and
their knives and even pistols, at the expense of public order” and worries that the
jeering incident had returned such “respectable outlawry” to the city (9).
Similar responses can be found in the College Scrapbook A (1816–48), which in-
cludes clippings dated November 1869 referring to a time “prior to the rebellion”
when a typical southern medical student carried “a large size club and a bowie knife”
and recalling that “Anti-slavery Fairs were held for years under the shadow of vio-
lence and threats, and the doors closed upon them by the Sheriff, in the name of the
Commonwealth, because it hurt the students’ feelings. . . . colored children, and men
and women too, held their lives cheap, when they met a party of students” (WMC,
College Scrapbooks, A, 4). Both writers felt that the jeering incident was a return to
those bad old days. A long article from the Philadelphia Press in the College Scrap-
book A (1816–48) recalls regular fights “every Saturday night for months together”
in the Walnut Street Theater (23). The writer notes, however, that the three students
he interviewed were “neither long-haired, nor slouch-hatted, nor nicotine-stained,
nor bowied and pistolled, nor in any way alarming to look upon or to contemplate” (24).
19. In the regular medical press, support for the male medical students was not
universal, although the terms of criticism were muted. In “Medical Lectures to
Mixed Classes,” the first statement on the jeering incident to appear in the Philadel-
phia Medical and Surgical Reporter, the editors mention “demonstrations, not be
approved in every respect” (21 [Nov. 20, 1869]: 325).
20. See the New York Medical Gazette, generally sympathetic to the women stu-
dents, which, in “The Pennsylvania Hospital Scandal,” advised them that “those who
needlessly seek martyrdom in opposition to established usages, seldom attract the
sympathy of the community, and rather weaken than strengthen the cause they advo-
cate” (294).
21. Medical and Surgical Reporter, “The Medical Profession and the Management
of Hospitals,” 21 (Dec. 11, 1869): 386. For the doctors’ petition, which was signed
by the entire medical establishment of Philadelphia, see WMC, College Scrapbooks,
A, 1816–48, 43, a newspaper clipping; or Medical and Surgical Reporter, “Remon-
strance against Mixed Clinics,” 21 (Nov. 27, 1869): 345–46.
22. Medical and Surgical Reporter, “The Pennsylvania Hospital Clinics,” 25 (Aug.
26, 1871), noted that the annual report of the Pennsylvania Hospital records com-
plaints from the medical staff that the separate clinics given to women students “have
much increased their labors, diminishing the time appropriated to patients” and that
the number of students attending the hospital clinics has declined from 500, includ-
ing 42 women, to 206, including 32 women. The report asked contributors for in-
structions and stated that if no instructions were received, “they [the managers] will
conceive that the whole matter of lectures to females is left to their judgment and
discretion” (200–201).
23. The statement by Ann Preston is collected in WMC, College Scrapbooks, A,
1816–48, 27–29, and was first printed as “Women as Physicians,” in the Philadelphia
Medical and Surgical Reporter 16, no. 18 (May 4, 1867): 391–94. Other newspaper
stories speak of a “card” circulated by Dean Ann Preston stating that the women
medical students only desired to attend clinics once a week and to see cases not
requiring exposure. I have not located that card, which may have been an alternate
273
publication of this statement. The most accessible copy of the letter is in Clara Mar-
shall, The Woman’s Medical College of Pennsylvania: An Historical Outline (Philadel-
phia: P. Blakiston, 1897), 45–53.
24. J. William White, M.D., “Memoir of D. Hayes Agnew, M.D., LL.D.,” Transac-
tions of the College of Physicians, 3d ser., 15 (Jan. 4, 1893): xxix–lxv.
25. Medical and Surgical Reporter (Philadelphia), “The Pennsylvania Hospital
and Female Students,” 22 (May 14, 1870): 420–21.
26. “The Medical Students Again,” Evening Bulletin (Apr. 28, 1870), clipping in
WMC, College Scrapbooks, #3, 1868, 1869, Jan. 1870–Aug. 1871, 85, ASCWM. For
additional responses to these pamphlets, see also pp. 86–89. The pamphlets are col-
lected in Men and Women Medical Students, No. 2 (Philadelphia, Apr. 1870), bound
with the Minute Book of the Pennsylvania Hospital Board of Managers, HLPH; see
also George Wood, M.D., et al., To the Contributors of the Pennsylvania Hospital
(Philadelphia, spring 1870), HLPH.
27. Medical and Surgical Reporter, “Philadelphia Hospital and Female Students,”
421.
28. See Medical and Surgical Reporter (Philadelphia), “The Female Students
Again,” 23 (Jan. 28, 1871): 85; and Medical and Surgical Reporter (Philadelphia),
“The Woman’s Medical College of Pennsylvania,” 23 (Feb. 11, 1871): 130.
29. Peitzman, “A New and Untried Course.”
30. O’Hara, Emerging Profession, 194–96.
31. For early feminist studies of science, see Evelyn Fox Keller, A Feeling for the
Organism: The Life and Work of Barbara McClintock (San Francisco: Freeman,
1983); Evelyn Fox Keller, Reflections on Gender and Science (New Haven, Conn.:
Yale University Press, 1985); and Sandra Harding, The Science Question in Feminism
(Ithaca, N.Y.: Cornell University Press, 1986). Early studies have been collected in
Nancy Tuana, ed., Feminism and Science (Bloomington: Indiana University Press,
1989). More recent work is included in Barbara Laslett, Sally Gregory Kohlstedt,
Helen Longino, and Evelynn Hammonds, eds., Gender and Scientific Authority
(Chicago: University of Chicago Press, 1996). A convenient account of this line of
study can be found in Evelyn Fox Keller and Helen Longino, eds., Feminism and
Science (New York: Oxford University Press, 1996).
32. Harriot Kezia Hunt, Glances and Glimpses: Or Fifty Years Social, Including
Twenty Years Professional Life (Boston: Jewett, 1856), 270.
33. Ruth Abram, “Will There Be a Monument?” in her “Send Us a Lady Physi-
cian”: Women Doctors in America, 1835–1920 (New York: Norton, 1985), 89.
34. See the Wood-Armitage scrapbook for a letter in the Philadelphia Press from
“A Woman” (Wood-Armitage, Scrapbook, no page number shown); and WMC, Col-
lege Scrapbooks, #3, 1868, 1869, Jan. 1870–Aug 1871, 87, for a letter signed “A
Mother” (not to be confused with the letter titled “A Mother” recounting the story
of the exposed maiden). The letters describe similar incidents at a mixed clinic held
either in 1863, according to “A Woman,” or in 1864–65, according to “A Mother.” At
a clinic on the use of forceps, the entire lecture was a discussion of the propriety of
mixed clinical lectures. The next Saturday, a prisoner was subjected to amputation of
his lower lip without anesthesia, “for the purpose of trying the nerves of the ladies
present, in the hope that the groans of the patient might drive them from the clinic”
274
(“A Mother”). The patient was held down, his lip was removed, and the points of his
mouth were drawn together so that his upper lip protruded “like a ruffle,” to the
“laughter and cruel jeers” of the male medical students (“A Mother”). The next pa-
tient, an Irishman whose dislocated hip had healed, was brought into the clinic and
told to strip, “Pat, never mind the ladies; take off your pants” (“A Woman”) or per-
haps, “Down with them, Sir; that is what the ladies come for” (“A Mother”). When
the patient complied, “the professor laughed and looked around upon the male stu-
dents, who, with but a few exceptions, hooted, laughed, clapped their hands and
stamped their feet.” After the lectures “we were compelled to march through a
double file of men, subject to their jeers and gazes.”
In response to the Philadelphia jeering incident, male students at Bellevue met to
consider the question of the continued presence of women students to the clinical
lectures; the 150 students who met were generally opposed to mixed lectures (Medi-
cal and Surgical Reporter [Philadelphia], “The Woman Question in New York,” 21
[Dec. 4, 1869]: 362–63) but refused to vote in support of a resolution against women’s
attendance at clinics (Medical Gazette, “Professional Items,” 3 [Nov. 27, 1869]: 307).
35. Thomas Neville Bonner, To the Ends of the Earth: Women’s Search for Educa-
tion in Medicine (Cambridge, Mass.: Harvard University Press, 1992), 140–42.
38. Mary Putnam Jacobi, “The Practical Study of Biology,” Boston Medical and
Surgical Reporter 120 (1889): 631–36, reprinted in Jacobi, Pathfinder, 458–62. “Prac-
tical Study” was given as a talk at the 1889 annual dinner of the Massachusetts Medi-
cal Society.
39. Anna L. Wharton, letter to her husband, Joseph Wharton, Mar. 12, 1856, RG5/
162: Joseph Wharton Papers, ser. 4.2, FHL.
40. Audrey B. Davis, “Louis Thomas Jerôme Auzoux and the Papier Mâché Ana-
tomical Model,” Estratto da atti del I congresso internazionale sulla ceroplastica nella
scienza e nell’arte, vol. 20 of series (Firenze: Biblioteca della “Rivista di storia della
scienze mediche e naturali,” 1977), 257–79. Thanks to Gretchen Worden of the Müt-
ter Museum for this citation.
41. Ladies’ Physiological Institute of Boston and Vicinity, Secretary’s Reports and
Board Meetings, vol. 1, Dec. 1850, Apr. 1851, Ladies’ Physiological Society Papers,
MC-236, Schlesinger Library, Radcliffe College. Tickets for the microscopic soirées
can be found in WMC, Deans Files, MCP-C4, Rachel Bodley, folder 11, 1886, Acc.
#291, ASCWM.
42. Sarah Mapps Douglass, letters to Rebecca White, Philadelphia, Feb. 9, 1862,
and two undated letters, Quaker Collection, Haverford College Library.
43. Barbara Stafford, Body Criticism: Imaging the Unseen in Enlightenment Art
and Medicine (Cambridge, Mass.: MIT Press, 1991). Emily Jane Cohen has extended
and qualified this analysis in her meditation on the medical hand as source of knowl-
edge, “Enlightenment and the Dirty Philosopher,” Configurations 5, no. 3 (fall 1997):
369–424. For a useful history of medical illustration, see Mimi Cazort, Monique Kor-
nell, and K. B. Roberts, The Ingenious Machine of Nature: Four Centuries of Art and
Anatomy (Ottawa: National Gallery of Canada, 1996).
44. For the edifying power of dissection, see Sappol, A Traffic of Dead Bodies.
275
45. For an account of mail-order physiology texts, see Michael Sappol, “Sammy
Tubbs and Dr. Hubbs: Anatomical Dissection, Minstrelsy, and the Technology of
Self-Making in Postbellum America,” Configurations 4, no. 2 (1996): 131–83.
46. “A Mother,” letter to the Herald Tribune, Mar. 5, 1870, WMC, College Scrap-
books, #3, 1868, 1869, Jan. 1870–Aug.1871, 86.
47. The Herald Tribune’s letter could not have been the first publication of this
story. The Tribune letter was published on March 5, 1870, but the editor of the New
York Medical Gazette had already read a version of it in the Church Union by March
4. As the Medical Gazette quotes it, the Church Union account reads:
We know of a recent case in an eminent medical school, in which a young woman suffering
from rheumatic fever was brought before the class without any matronly attendance. With
closed eyes she lay while the professor called attention to her case, point by point. The
final statement made was, that in such a case, at such a stage of development, a minute rash
might be expected upon the stomach and bowels—and the professor, without a thought of
its indelicacy, before the whole class, made an open examination! The girl lay as one dead.
But with the act of denuding the color rose along her face to the roots of her hair. (Medical
Gazette, “Cliniques for Women,” 4 [Mar. 4, 1870]: 164)
The editors of the Medical Gazette did not approve of this examination: “To uncover
an unfortunate woman in a college amphitheatre . . . is a proceeding, the agony of
which to the patient is not compensated for by any adequate advantage to the class.”
It seemed unlikely to them that a rheumatic fever patient would have an abdominal
rash; they were skeptical of the eminence of the medical school. But, unlike the edi-
tors of the Church Union, they did not therefore conclude that women should attend
clinical lectures: exposure before “a promiscuous assemblage of both sexes” would
be even more shocking than before an audience of men; instead, clinical instruction
should take place on the ward, in small groups.
48. Emily A. Varney-Brownell, M.D., “A Case of Hemoptysis,” in WMC, Alumnae
Association, Report of the Proceedings of the Fourteenth Annual Meeting of the Alum-
nae Association of the Woman’s Medical College of Pennsylvania (Philadelphia: Rod-
gers Printing Co., 1889), 89–90, MCP Collection, ASCWM.
49. Clipping of Mary Pratt, M.D., “Clinics—the Other Side,” letter to the New
York Herald Tribune (Mar. 1870), in WMC, College Scrapbooks, #3, 1868, 1869, Jan.
1870–Aug. 1871, 86.
50. Charles Reade, The Woman-Hater (Paris and Boston: Grolier Society, n.d.;
original publication 1877), vol. 1, 218.
51. For praise of the women medical students at the Blockley, see WMC, College
Scrapbooks, A, 1816–48, 22. For similar comments on Zurich, see p. 12 in the same
scrapbook.
52. Stephen Smith, M.D., “The Medical Co-education of Women,” appendix to
Elizabeth Blackwell, Pioneer Work in Opening the Medical Profession to Women
(New York: Schocken, 1977; original publication, 1895), 255–59, quotation on 258.
Among the many interesting issues in this story is the question of Blackwell’s aware-
ness of the situation: her note argued that the professor of anatomy must necessarily
be a “reverent” man, and in the text of her autobiography, she does not even raise
276
the question of his propriety. But the essay by Smith, written in New York City in
1892, must have been based on information given by Blackwell. Reversing Preston’s
kidnaping of Meigs, Blackwell gave her most transgressive account of her own educa-
tion as a hostage to a male writer.
53. WMC, College Scrapbooks, A, 1816–48, 25, clipping from the Philadelphia
Press, Nov. 12, 1869.
54. WMC, College Scrapbooks, A, 1816–48, “Hospital Clinics,” letter to the Eve-
ning Bulletin (no page number shown).
55. Medical and Surgical Reporter, “Remonstrance against Mixed Clinics,” 345–
46. The “Remonstrance” was widely reprinted and commented upon in the general
press, often unfavorably.
56. WMC, College Scrapbooks, A, 1816–48, “Hospital Clinics”; for the threat
posed to male spectators by female immodesty, see Mary Ryan, Women in Public:
Between Banners and Ballots (Baltimore: Johns Hopkins University Press, 1990), 72.
57. WMC, bound volume of annual announcements for 1866 through 1879, clip-
ping pasted in at the end of the announcement for 1870–71, MCP Collection,
ASCWM.
58. Sarah Hibbard, manuscript draft of lectures and sermons.
59. Ryan, Women in Public, 79–80.
60. The quotation is from p. 22 of Abram Smith, “An Essay on the Moral and
Physical Education of Females” For the Degree of Doctor of Medicine in the Uni-
versity of Pennsylvania by Abram Smith of Easton, Northampton County, State of
Pennsylvania, Residence No. 91 South Eighth Street, Philada., Preceptor S. Morton
Zulich M.D., Duration of Studies 3 years, Presented Feby 1850, 22, PA.
61. Smith, “Moral and Physcial Education of Females,” 24.
62. Smith, “Moral and Physical Education of Females,” 23.
63. White, “Memoir of D. Hayes Agnew,” lvi.
64. Diana Long Hall, “Eakins’s Agnew Clinic: The Medical World in Transition,”
Transactions and Studies of the College of Physicians of Philadelphia: Medicine and
History, ser. 5, 7, no. 1 (Mar. 1985): 26–31, brief quotation on 26.
65. D. Hayes Agnew, M.D., Theatrical Amusements; with Some Remarks on the
Rev. Henry W. Bellows’ Address before the Dramatic Fund Society, N.Y. (Philadel-
phia: Wm. S. Young, 1857), 10, 12.
66. Agnew, Theatrical Amusements, 7, 8.
67. D. Hayes Agnew, M.D., Lecture Introductory to the One Hundred and Fifth
Course of Instruction in the Medical Department of the University of Pennsylvania,
delivered Monday, October 10, 1870 (Philadelphia: Published by the class, 1870), 18.
68. WMC, College Scrapbooks, A, 1816–48, 41.
69. O’Hara, Emerging Profession, 88.
70. Kaiser, Chaff, and Peitzman, “A Philadelphia Medical Student of the 1890’s,”
233.
71. Edith Flower Wheeler, M.D., “She Saunters Off into Her Past,” autobiog-
raphy, typescript, 1946, 83, Wheeler Papers, Deceased Alumnae Files, MCP Collec-
tion, ASCWM. I am grateful to Steven Peitzman for this reference.
72. Wheeler, “She Saunters Off into Her Past,” 108.
277
73. Anne Walter Fearn, My Days of Strength: An American Woman Doctor’s

Forty Years in China (New York: Harper and Brothers, 1939), 14. I am grateful to
Steven Peitzman for this reference.
74. Michael Sappol, in his Traffic in Dead Bodies, discusses dissection as a consti-
tuting practice of the masculine medical profession and argues that dissection prac-
tices by women physicians, or at women’s schools, were distinct from those at men’s
schools and much less intense (chap. 3).
75. WMC, “First Annual Announcement of the Female Medical College of Penn-
sylvania for the session of 1850–51 . . . ,” 12, MCP Collection, ASCWM.
76. WMC, Faculty Minutes, 1850–74, Oct. 28, 1850, MCP Collection, ASCWM.
77. Erasmus Wilson, M.D., A System of Human Anatomy, General and Special,
ed. Paul Goddard, fourth American from the last London ed. (Philadelphia: Lea and
Blanchard, 1850), 219. Preston’s copy is held in the ASCWM.
78. WMC, Alumnae Association, Transactions of the Twenty-seventh Annual
Meeting, 1902, “Ida E. Richardson,” 25–26.
79. Ruth Richardson, Death, Dissection, and the Destitute (Harmondsworth: Pen-
guin, 1989), 31.
80. WMC, Alumnae Association, Transactions of the Twenty-seventh Annual
Meeting, “Ida E. Richardson,” 25.
81. Hannah Longshore, “Autobiography,” second draft, undated, Longshore Pa-
pers, ASCWM; Mary Putnam Jacobi, autobiographical manuscript, typescript, 1902,
Mary Putnam Jacobi Collection, Jacobi Papers, a-26, folder 2, SL.
83. Blackwell, Pioneer Work, 59.
84. Galen, On the Natural Faculties, trans. Arthur John Brock, Loeb Classical Li-
brary (Cambridge, Mass.: Harvard University Press, 1952), 2.3.
85. Agnew, Lecture Introductory, 24–25.
86. Mary Putnam Jacobi, “A Martyr for Science,” reprinted in her Stories and
Sketches (New York: Putnam’s Sons, 1907).
87. For nineteenth-century reading practices, see Jane Tompkins, Sensational
Designs: The Cultural Work of American Fiction, 1790–1860 (New York: Oxford Uni-
versity Press, 1985); and Richard Brodhead, Cultures of Letters: Scenes of Reading
and Writing in Nineteenth-Century America (Chicago: University of Chicago Press,
1993).
88. Julie Elison, “Race and Sensibility in the Early Republic: Ann Eliza Bleeker
and Sarah Wentworth Morton,” in Subjects and Citizens: Nation, Race, and Gender
from Oroonoko to Anita Hill, ed. Michael Moon and Cathy Davidson (Durham, N.C.:
Duke University Press, 1995), 57–86, quotation on 60.
89. WMC, Deans Files, MCP-C4, Rachel Bodley, folder 11, 1886, Acc #291,
ASCWM.
90. Agnes C. Vietor, ed., A Woman’s Quest: The Life of Marie Zakrzewska, M.D.
(New York: Appleton, 1924), 441.
91. Mark Twain and Charles Dudley Warner, The Gilded Age: A Tale of Today, ed.
Shelley Fisher Fishkin (New York: Oxford University Press, 1996; original publica-
tion, 1873), 148.
278
92. Medical and Surgical Journal (Philadelphia), “Outrage at a Woman’s Medical

College,” 7, no. 8 (Feb. 23, 1871): 133–34.
93. WMC, College Scrapbooks, A, 1816–48, 2, clipping from Evening Bulletin,
Nov. 8, 1869.
94. WMC, College Scrapbooks, A, 1816–48, 25, clipping from the Philadelphia
Press, Nov. 12, 1869.
95. WMC, College Scrapbooks, A, 1816–48, Faculty Statement, 27.
96. WMC, College Scrapbooks, A, 1816–48, Faculty Statement, 27.
97. WMC, College Scrapbooks, #3, 1868, 1869, Jan. 1870–Aug. 1871, 29.
98. Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians
in American Medicine (New York: Oxford University Press, 1985), chap. 3.
99. Vietor, A Woman’s Quest, 18.
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UNPUBLISHED THESES BY NINETEENTH-CENTURY

MEDICAL STUDENTS
Note: In thesis titles, I have reproduced the orthography of the title page as closely
as possible, adding quotation marks to designate the main title.
UNIVERSITY OF PENNSYLVANIA MEDICAL DEPARTMENT
Allen, Joshua. “An Essay on Organic Life Force” for the Degree of Doctor of Medi-
cine, by Joshua G. Allen, County of Delaware, State of Pennsylvania. Preceptor
Dr. Charles J. Morton of Pa. Duration of studies three years. Presented 2nd mo.
15th, 1850. PA.
Cook, John S. “An Essay on Diabetes” for the Degree of Doctor of Medicine, by
303
Works Cited
John S. Cook, Easton, Northampton County, Penna. Preceptor Lewis C. Cook,

M.D., 1850. PA.
Corson, Thomas. “An Essay on Health versus Fashion” for the Degree of Doctor of
Medicine, in the University of Pennsylvania. By Thomas J. Corson, of New Hope,
Bucks county, State of Pennsylvania. Residence in city, 293 Race Stre., Preceptor,
Chas. Foulke, M.D., Duration of studies, three and a half years. Presented, Jany
18th, 1851. PA.
Crawford, S. Wylie. “An Essay on Hypertrophy and Atrophy” for the Degree of Doc-
tor of Medicine in the University of Pennsylvania. by S. Wylie Crawford of
Philad., State of Pennsylvania. Residence—Philadelphia, Arch St. above. Precep-
tor, Wm. E. Horner, M.D. Duration of Studies, three years; Presented, February
4th, 1850. PA.
Richardson, John P. “Enteric or Typhoid Fever,” Department of Medicine, University
of Pennsylvania. Preceptor H. D. W. Pawling, Department of Medicine. Feb 17,
1863. PA.
Rivins, Jesse. “An Essay on Auscultation in the Diagnosis of Pulmonary Disease.” For
the Degree of Doctor of Medicine in the University of Pennsylvania by Jesse A.
Rivins of Rutherford County, Tennessee. Preceptors. Watson and Wendel. Dura-
tion of studies 3 years and 4 months. Presented Jan 22nd, 1850. PA.
Sale, John W. “An Essay on Haemoptysis” For the Degree of Doctor of Medicine in
the University of Pennsylvania, by John W. Sale, of Bedford County, State of Vir-
ginia. Residence in the City No 13th Filbert St. Preceptor R. A. Sale, M.D. Dura-
tion of Studies 3 years. Presented on the 15th of Jany, 1850. PA.
Smith, Abram. “An Essay on the Moral and Physical Education of Females” For the
Degree of Doctor of Medicine in the University of Pennsylvania by Abram Smith
of Easton, Northampton County, State of Pennsylvania, Residence No. 91 South
Eighth Street, Philada. Preceptor S. Morton Zulich M.D. Duration of Studies 3
years. Presented Feby 1850. PA.
WOMAN’S MEDICAL COLLEGE OF PENNSYLVANIA: CLASS OF 1852
Ellis, Susanna H. “A Disquisition on the Influence of the Nervous System on the

Functions of Respiration and Digestion.” Respectfully submitted to the Faculty of
the Female M. College of Pennsylvania as an inaugural thesis; for the Degree of
M.D. By Susanna H. Ellis of Philadelphia. Preceptor J. W. Comfort, M.D. Period
of study 3 years, 1851. ASCWM.
Hunt, Angenette. “A Disquisition on the True Physician.” Respectfully submitted to
the Faculty of the Medical College of Pennsylvania, as inaugural Thesis for the
degree of M.D. by Angenette Hunt of Hamilton, N.Y. Term of study 3 years. Pre-
ceptor Dr. H. N. Hunt. Philadelphia, Nov. 26th, 1851. ASCWM.
Longshore, Anna M. [Anna Longshore-Potts]. “A Disquisition on Electricity.” Re-
spectfully submitted to the Faculty of the Female Medical College of Pennsylvania
As an Inaugural Thesis For the Degree of M.D. By Anna M. Longshore of Bucks
County Pa. Period of Study three years. Preceptor J. S. Longshore, M.D. Novem-
ber 1851. ASCWM.
Longshore, Hannah. “A Disquisition on Neuralgia, its Treatments,” respectfully sub-
304
Works Cited
mitted to the Faculty of the Female Medical College of Pennsylvania as an Inaugu-

ral Thesis for the Degree of M.D. by Hannah E. Longshore of Philadelphia. Period
of Study, Three Years. Preceptor Dr. Joseph S. Longshore, M.D., November
1851. ASCWM.
Mitchell, Frances. “A Disquisition on Chlorosis.” Respectfully submitted to the Fac-
ulty of the Female Medical College of Pennsylvania as an Inaugural Thesis for
the degree of the Doctorate in the Female Medical College of Pennsylvania. By
Frances G. Mitchell of England. Period of Study three years. Preceptor J. F. X.
McCloskey, M.D., Philadelphia, Dec 1st 1851. ASCWM.
Preston, Ann. “A Disquicition on General Diagnosis,” Respectfully submitted to the
Faculty of the Female Medical College of Pennsylvania as an Inaugural Thesis for
the Degree of M.D. by Ann Preston of West Grove, Penna, term of study 3 years,
preceptor, N. R. Moseley, M.D., Phila, Nov. 26th, 1851. ASCWM.
Sawin, Martha. “A Disquisition on Anaemia.” Respectfully Submitted to the Faculty
of the Female Medical College of Pennsylvania as an Inaugural Thesis For the
Degree of M.D. by Martha A. Sawin of Boston Mass. Period of Study 3 years.
Preceptors E. C. Rolfe, M.D., W. M. Cornell, M.D. ASCWM.
Way, Phebe. “A Disquisition on Wounds.” Respectfully submitted to the Faculty of
the Female Medical College of Pennsylvania. As an Inaugural Thesis for the De-
gree of M.D. by Phebe M. Way of Chester County, Pennsylvania. Preceptor, J. W.
Comfort. ASCWM.
Adams, Charlotte. “Disquisitio De Physiologus Effectis Nutricum A Lactatione

Nimia.” Verecundie Submittitur ad Professores Feminae Medicinalis Collegii
Pennsylvaniae, Quasi Inauguratum Propositum Pro Grado Doctoris Medicinae.
Per Charlotte G. Adams, Bostonae. Praeceptores Guilielmus M. Cornell M.D.,
Enochus C. Rolfe, M.D., Tempus Studii—Tres Annos. Philadelphia, Januaris
Primo Die. Annodomini MDCCCLII. ASCWM.
Anderson, Annah N. S. “A Disquisition on General Physiology,” Respectfully Submit-
thesis, for the Degree of Doctorate of Medicine. By Annah N. S. Anderson of Bris-
tol, Bucks County Pennsylvania. Period of study 3 years. Preceptor Dr. Benjamin
Malone Philadelphia. January 1853. ASCWM.
Beverly, Julia A. “A disquistion on Iron,” Respectfully Submitted to the Faculty of the
Female Medical College of Pennsylvania As an Inaugural Thesis for the Degree of
Doctor in Medicine, January 7th, 1853 by Julia A. Beverly of Prov. Rhode Island.
Preceptors, W. M. Cornell, M.D. and E. C. Rolfe, M.D. Period of study three
years. ASCWM.
Ellis, Hannah W. “A Disquisition on Labor.” Respectfully submitted to the Faculty
of the Female Medical College of Pennsylvania as an Inaugural Thesis for the
Degree of Doctorate of Medicine by Hannah W. Ellis of Pennsylvania. Period of
study 3 years. Preceptor [ ] Philadelphia, 1853. ASCWM.
Johnson, Henrietta W. “A disquisition on the Skin and its Functions”: Respectfully
Submitted to the Faculty of the Female Medical College of Pennsylvania as an
305
Works Cited
Inaugural thesis For the degree of M.D. by Henrietta W. Johnson of New Jersey.
Preceptor I. W. Redfield M.D., Term of Study Three Years. ASCWM.
Minnis, Maria. “Disquisition on Medical Jurisprudence” Respectfully Submitted to
the Faculty of the Female Medical College of Pennsylvania as an Inaugural Thesis
for the Degree of the Doctorate in Medicine, by Maria Minnis of Phelps, New
York. Period of study, four years. Preceptors, Caleb Bannister, M.D. and G. F. Hor-
ton. Philadelphia, January 10th, 1853. ASCWM.
Montgomery, Augusta. “A Disquisition on the Medical Education of Woman” Re-
spectfully Submitted to the Faculty of the Female Medical College of Pennsylva-
nia as an Inaugural Thesis for the Degree of Doctor of Medicine. By Augusta R.
Montgomery. Residence: Attica, New York. Term of Study. Three years. Precep-
tors: Drs. Hayes and Hadley. Philadelphia, January 1st, 1853. ASCWM.
Richardson, Margaret. “A Disquisition on Phthisis Pulmonalis,” respectfully Submit-
Theses for the Degree of the Doctorate in Medicine. By Margaret Richardson
of Pennsylvania. Period of Study, three years, Preceptor, J. S. Longshore, M.D.,
Philadelphia, December 30th, 1852. ASCWM.
Putnam, Mary. “Theorae ad Lienis officium.” Thesis Medicinae Collegii Foeminis

Pennsylvaniae Facultati submissa ad gradum obtinendum Medicinae Doctoris.
Maria C. Putname scripta. New York, 1864. ASCWM.
Hall, Sarah. “A Thesis on The Physical and Moral Effects of Abortion.” Presented to
the Faculty of the Woman’s Medical College of Pennsylvania by Sarah C. Hall,
Philadelphia Session of 1869–70. ASCWM.
Wiley, Caroline V. “A Thesis on Fibromata,” Presented to the Faculty of the Woman’s

Medical College of Pennsylvania for Degree of Doctor of Medicine by Caroline
Wiley, Philadelphia, Session of 1877–78. ASCWM.
Young, Georgiana. “A Thesis on Opium,” Presented to the Faculty of the Woman’s
Medical College of Pennsylvania, for degree of Doctor of Medicine by Georgie E.
Young, Philadelphia, Session of 1877–8. ASCWM.
Bennett, Juan F. “Sanitary Chemistry.” Submitted to the Faculty and Corporators of

the Woman’s Medical College for the Degree of Doctor of Medicine. Juan F. Ben-
nett, 1888. ASCWM.
306
Index
abolitionism, 57, 73–74, 99 Biology and Gender Study Group, 11
abortion, 32–35, 235n56 birth, 51–53
Academy of Sciences, 149 Blackwell, Elizabeth, 4, 7, 27, 32, 50, 62, 63,
Adams, Charlotte, 106 119, 149, 150–51, 155, 157, 166, 177, 191;
African Americans: theses by, 113–21; as and anatomy, 206, 218–19, 276n52
women physicians, 13, 14, 49, 84; as writ- Blackwell, Emily, 8, 62, 149, 155, 167
ers, 71. See also medical writing: and race Blankenburg, Lucretia, 122, 255n5
Agnew, D. Hayes, 197–98, 200, 219; anti- Blockley Hospital, 194, 198, 200, 204, 206
theatrical writing, 209–11 Bodley, Rachel, 219–22
Alcott, Louisa May, 21 body, visual representations of, 98–99, 149,
Alsop, Gulielma Fell, 105 156, 163–64, 186–87, 201–3, 217–18,
American Journal of Obstetrics, 185–87 249n55
American Medical Association, 7, 9, 20 Boston Lying-In Hospital, 8
amphitheater, 194–95, 204, 207, 210–11 Boston Medical and Surgical Journal, 223
anatomy, 48, 64, 203, 215–22. See also Boylston Prize for Medical Writing. See
dissection Jacobi, Mary Putnam: Boylston Prize
Anderson, Caroline Still Wiley, 113, 114, Braidotti, Rosi, 71
116–18, 120 Bright’s disease, 146, 162
Anderson, Matthew, 113 Bruns, J. Dickson, 83
anonymity, 61–62, 69–71, 79, 133, 147, 155, Butler, Judith, 61, 188
158, 173, 177–78, 189
Anthony, Susan B., 65, 116
Campbell, Jane, 256n14
auscultation, 109–10
autobiography, 131–38; of Quakers, 132–33; Carpenter, William, 101, 105, 106
of women, 257n31 Cass, Edward, 140–41
Chenail, Ronald, 24–25, 233n27
cinchona, 129–30, 138
Baker, C. Alice, 173 Clarke, George, 147, 172–73, 176
Barrows, Isabel, 113 Cleveland, Emeline, 75
Beecher, Catherine, 176 Cleveland Medical College, 223
Belenky, Mary, 10 Cole, Rebecca, 49, 50, 119
Bell, Peter, 26 collaboration, 147, 169–72, 190
Bellevue Hospital, 200 College of Physicians of Philadelphia, 132
Bennet, Juan, 119–20 conception, 140
Berean Presbyterian Church, 113 Corson, Hiram, 75, 85
Biddle, William, 195 Corson, Marcus, 195
biography, 132–35 Corson, Thomas, 85–91
307
Index
Crawford, S. Wylie, 108–9 feminism, 126, 149; and science studies, 10–
cross-dressing, as writing strategy, 14, 56, 59– 11, 98, 141–44, 199, 248nn53–54, 274n31
80, 119, 142, 147, 167, 172, 189 Fisk University, 116
Crumpler, Rebecca Lee, 13, 50–54; Book of Flexner Report, 9
Medical Discourses, 51–54, 71 Foucault, Michel, 35–36, 175
Frankenstein, 215
DaCosta, Jacob, 196 Freud, Sigmund, 13
Dana, Richard Henry, 64 Fulton, W., 25, 233n28
Darlington, Hannah Monaghan, 57 Fussell, Benjamin, 57
dead bodies, ownership of, 37 Fussell, Edwin, 21, 57, 59, 62, 151
dead house, 3, 4, 15. See also anatomy; Fussell, Rebecca, 131, 258n32
dissection
deictic system, 41–43 Galen, 218
Derbyshire, A. J., 195 Garber, Marjorie, 69, 189
dissecting room, 212–15 gender, 132, 167; and autobiography, 131; in
dissection, 15, 71–72, 102, 202, 220 fig. 17, Mary Putnam Jacobi, 171–72; language
221 fig. 18; as demonstration, 222; and variation and, 18; and medicine, 4, 5, 12;
Mary Putnam Jacobi, 148, 156; and Han- performance of, 6, 17, 56, 61, 68, 71, 92,
nah Longshore, 136. See also anatomy 98, 147, 150, 169–70, 188–90; and science,
domesticity: and physicians, 88–90, 185; and 12, 141–42, 226. See also feminism;
women’s sphere, 66–67 women
Douglass, Frederick, 131, 258n32 Gilligan, Carol, 10
Douglass, Sarah Mapps, 202 Gilman, C. P., 15, 147, 182, 268n134
Drake, Daniel, 81 Gleason, Rachel, 19, 29, 32, 93
dress, as metaphor, 169, 189, 195. See also grammatical metaphor, 162–63, 184
cross-dressing, as writing strategy; Quak- Greek, in student theses, 111
ers: dress; travesty, as writing strategy Gregory, Samuel, 7, 21, 63, 65, 81
dress reform, 6, 88, 96, 127 Grier, Eliza, 113, 115, 116
DuBois, W. E. B., 49, 120 Gross, Samuel, 89–90, 197
gynecology, 150, 186
Eakins, Thomas, 210
Eclecticism, 6, 7, 93, 127, 131, 190, 248n41 Hahnemann Medical College, 195, 197
Eclectic Medical Journal, 89–90, 247n34 Hall, Sarah, 235n56
economy, visual, 193, 206–9, 212, 223 Halliday, M. A. K., 85–86, 162, 184
Edinburgh, Royal Infirmary of, 26 Haraway, Donna, 11, 144
Ellis, Hannah, 106, 110 Harmonial Circle, 125, 128, 146
Ellis, Susanna, 104 Hartshorne, Henry, 75
Emerson, Ralph Waldo, 160–61 Harvard Medical School, 29, 172–73,
Engels, Friedrich, 168 199–200
ethos, 11 Harvey, Elwood, 62
euphemism, 25–26 Hatton, Sylvia, 213
Evening Bulletin, Philadelphia, 196 health, laws of, 53, 67, 98–99
Evening Post, New York, 152 heart history, 13, 19, 28–34, 40
Henry, Frederick, 150
“Fadden, Chimmie,” skeleton, 213 Herald Tribune, New York, 203
Fearn, Ann Walter, 212 heredity, 101, 184
Female Medical College of Pennsylvania. Hibbard, Sarah, 208
See Woman’s Medical College of Hills, Laura, 214 fig. 15
Pennsylvania Holmes, Oliver Wendell, 83, 155
308
Index
homeopathy, 6, 14, 29, 95, 129–30, 131, 146, Kerr, Mark, 76, 77
190, 195 Kirkbride, Thomas, 34, 74, 243n59
Howard University, 8, 113 Kulmus, Johann, 218, 220 fig. 17
Hunt, Angenette, 90–95, 97, 100, 248nn39,
51 Laqueur, Thomas, 174, 266n102
Hunt, Harriot Kezia, 19, 29–30, 33, 65, 93, Lathrop, Ruth, 116
105, 173, 199 Latin: and Mary Putnam Jacobi’s thesis, 151;
Hunt, Nelson, 90, 94 required for doctors, 7, 81–82; student
Hyman, Morrill, 173 writing in, 106
hysteria. See Jacobi, Mary Putnam; Mitchell, Latour, Bruno, 11
S.Weir Leidy, Joseph, 197
Liasons dangereuses, Les, 22
impregnation, 139–41 Lily, The, 122
Institute for Colored Youth, 50 Lister, Joseph, 26, 146
International Medical Congress, 158, 160, literacy: and medical education, 51, 151,
163 244n15; and professionalization of medi-
irony, 92–94, 186 cine, 81
Livezy, Abraham, 127
Jacobi, Abraham, 147, 167–69; Infant Diet, Loguen, Sarah Miranda, 116
170–71 Longshore, Hannah, 4–5, 14, 94, 104, 105,
Jacobi, Mary Putnam, 4–5, 14, 124, 146–92, 122–45, 150, 188, 225, 254n1; “A Case of
201, 226, 259n1, 261n31; autobiography, Conception,” 138–44; as Demonstrator of
148; Boylston Prize, 14, 147, 150; and dis- Anatomy, 128; and dissection, 218–19;
section, 218–19; early writing, 153–64; Es- reply to toast, 123–38; thesis, 128; writing
says on Hysteria, 180–83; fiction, 155–58; process, 135–38
and hysteria, treatment of, 182–83; Infant Longshore, Joseph, 59, 80, 101, 104, 106,
Diet, 170–71; mature medical writing, 122, 127–29, 130, 139, 195, 255n1
178–88; Medical Record letters, 158–64, Longshore, Thomas, 122, 127–28, 130; “Auto-
262n32; in Paris, 152–66; and the Paris biography,” 133–35; George Fox Inter-
Commune, 164–66; pathological talks, preted, 134–35, 254n1
167, 262n85; physiological writing, Longshore-Potts, Anna, 90, 95–96, 97, 105,
183–89; Question of Rest for Women dur- 122, 248n51, 255nn1, 3
ing Menstruation, 14, 147, 172–78, 189; Ludmerer, Keith, 9
Stories and Sketches, 148, 152–53, 155–58,
262n36; Use of the Cold Pack, 179–80; and Marsh, Mary Montgomery, 214 fig. 15
Woman’s Medical College of Pennsylvania, Martin, J. R., 85–86
191; on women and medicine, 190–91 Marx, Karl, 168
Jefferson Hospital, 34, 42, 44, 194 masquerade, as writing strategy, 5
Jefferson Medical College, 36–41, 130, 225 masturbation, 26, 31–32
Jex-Blake, Sophie, 166, 201 materia medica, 76, 77, 149, 166
Johns Hopkins University Medical School, 9 Mayflower, The, 122
Johnson, Halle Tanner, 118 McClintock, Barbara, 8
Johnson, Henrietta, 106–7 McCloskey, F. X., 106, 111–12
Johnson, William, 62, 127 McCully, S. E., 26
Jordanova, Ludmilla, 163–64 Medical and Surgical Observer, 71
Judson, Eliza, 73, 74 Medical and Surgical Reporter, Philadelphia,
25, 61, 76, 138–41
Kane, Elisha, 83, 85, 103 medical care, 8–9, 16–17, 24–25, 28–34, 44;
Keller, Elizabeth, 31, 197 quietist, 86–87, 96–97, 108. See also medi-
Keller, Evelyn Fox, 11, 98, 144, 199 cal diagnosis; surgery
309
Index
medical consultation, 26–27, 93 menstruation, 174, 185–86

medical conversations, 16–28, 48, 54–56, Meyer, Annie Nathan, 151, 190
232n4; contemporary, 19; ethnographies Michigan, University of, 200
of, 34–35; linguistic studies of, 17–18, 19; microscope, 16, 63, 160, 201
narrative in, 35; negotiation in, 37–38; Minnis, Maria, 235n56
questions in, 35; and race, 50 Mitchell, Frances, 104, 105–6, 111–12
medical diagnosis, 16–17, 34–35, 36–40, 43, Mitchell, S. Weir, 15, 75, 179–80, 182, 197,
44 268n128
medical education, 7, 243n1; clinical lec- Morantz-Sanchez, Regina Markell, 8, 120
tures, 15, 193–212; and co-education, 9, Morris, Rebecca, 57
98–201, 207, 225; curricular reform, 70, Moseley, Nathaniel, 58, 59
72; and didacticism, 83; of Mary Putnam Mott, Anna, 234n39
Jacobi, 151–54; of Hannah Longshore, Mott, Lucretia Coffin, 64, 125
126–32; of Ann Preston, 58–59; Ann Pres- Mount Sinai Hospital, 149, 191
ton’s theories of, 61–73; for women, 7–10, Myers, Jane, 122
43–44, 61–73, 149; writing in, 80–81
medical examination, 16, 18, 19–20, 22–25, 39 narrative: of disease, 102, 142. See also auto-
medical histories, 13, 17–18, 23, 28–49, 34– biography; medical conversations: narra-
49, 36–37; contemporary, 44–45; at Jeffer- tive in; medical histories: narrative in; rhet-
son Hospital , 36–41; narrative in, 38–39, oric: argument from progress
40, 43, 46–47; at Woman’s Hospital of National College of Medicine, 222–23
Pennsylvania, 45–59 National Medical Association, 71
Medical Journal, 168 neurasthenia. See Jacobi, Mary Putnam;
medical jurisprudence, 32, 235n56 Mitchell, S. Weir
medical lexicon, 40, 43, 47–48, 85, 87, 91– Neurological Society, 149
92, 96, 100–101, 159–60, 162–63, 184 New England Female Medical College, 4, 7,
Medical Library and Journal Association of 21, 48
New York, 149 New England Hospital for Women and Chil-
Medical Record, 149, 152, 158–64 dren, 4, 8
medical schools. See specific schools New Jersey, Medical Society of, 85, 88
medical writing, 12; and belles lettres, 82– New Orleans Sunday Times, 152
84; case study, 103, 138–44, 233n11; clini- New York College of Pharmacy, 161–62
cal notebooks, 36–49, 41–44; competi- New York County Medical Society, 149, 167
tions, 173, 266n107; conversations New York Hospital, 70
recorded in, 18–19, 21–25; correspon- New York Infirmary for Women and Chil-
dence, 138–44, 158–64; genres, 5, 14, 141; dren, 36, 192
illustrations in, 187; nominalization in, 85– New York Pathological Society, 149, 166, 168
87, 96, 163, 184; popularization, 170–71; New York State Constitutional Convention,
and publication, 82; and race, 53–54, 149
106–7, 118; strategies, 5–6; student theses, New York Tribune, 196
14, 64, 80–121, 128, 151; surveys, 14, 149, North American Journal of Homeopathy, 129
174–77; and women, 12. See also Jacobi, North American Medical Review, 116
Mary Putnam: Boylston Prize; medical his- novel: as influence on medicine, 21; as model
tories; medical lexicon for medical practices, 218–19; women phy-
medicine: and gender, 4, 5; and professional- sicians in, 238n106. See also Reade,
ization, 6–7, 81, 92; and science, 87. See Charles; Twain, Mark
also physicians nurses, 61, 74, 75
Meigs, Charles, 22–25, 27, 33, 40, 65, 197,
237n79 Oberlin College, 113
Meigs, J. Forsyth, 75, 195 Oberlin Ladies’ Literary Society, 116
310
Index
obscenity, 25–26 Pratt, Mary, 205

Obstetrical Society of New York, 149, 186 Preston, Ann, 4–5, 13, 57–79, 90, 97, 122,
opium, 118–19 125, 126, 130, 131, 133, 146, 151, 157,
orgasm, 31, 235n54 167, 173, 188, 190, 222, 225, 241n18; anat-
Osler, William, 132, 258n35 omy text of, 216–17; hospitalized, 74,
ovaries, 106, 127, 174 243n59; and Mary Putnam Jacobi, 150–52;
and the jeering incident, 193, 198, 242n39;
Pancoast, Seth, 59, 127 as lecturer, 58–59, 68–69, 95, 201–3; medi-
Passmore, Lavinia, 57 cal education of, 58–59; and Philadelphia
pathological cabinet, 42 County Medical Society, 75–79; as teacher,
pathology, 109, 167 59, 84; and Woman’s Medical College, 58–
patients: compliance of, 27; education of, 28, 73, 240nn15–16, as writer, 62–73. See also
51, 201–3; public treatment of, 203–6, cross-dressing, as writing strategy
274n34, 276n47; women as, 17 Preston, Lavinia, 57
Payne Normal School, 116 Putnam, Haven, 151
pediatrics, 147, 168 Putnam, Ruth, 148, 169
Penn Medical University, 44, 72, 122, 128, Putnam’s Monthly, 152–53, 155, 164–65
195, 197, 199
Pennsylvania, University of, 124–25; School quackery, 42, 76; and literacy, 81
of Medicine, 14, 22, 71–72, 80, 84, 85–91, Quakers (Religious Society of Friends), 7,
95, 100, 107–11, 120–21, 151, 194, 211, 132; biography, 132–35; dress, 73, 196;
225, 245n18 Hicksite Quakers, 64, 73, 125, 128, 133;
Pennsylvania Hall, 57 hospitals of, 36, 193–94; inner light, doc-
Pennsylvania Hospital, 61, 70, 211, 223; In- trine of, 77
sane Department of, 34, 74. See also Wom- Queen’s University, Kingston, 201
an’s Medical College of Pennsylvania: jeer-
ing incident at Pennsylvania Hospital race, in medical writing, 53–54
Pennsylvania State Medical Society, 82 Reade, Charles, 158, 205–6
Pepper, William, 132 Reber, J. W. H., 36, 40, 44
personification, 88 Réclus family, 153, 156, 164, 166
Peterson, Linda, 133 register, of health, 14, 84, 85–99, 104, 161,
pharmacy, 125–26 185; of medicine, 14, 84, 99–112, 161
Phelps, Elizabeth Stuart, 152 registers, linguistic, 25
Philadelphia County Medical Society, 26, 61, rest cure, 15. See also Mitchell, S. Weir
72, 113, 150, 167, 191, 193 rhetoric, 13, 144, 245n20; argument from
Philadelphia Press, 206 consistency, 78, 223–24; argument by nega-
physicians: authority of, 22, 24, 31, 56, 88– tion, 178; argument from progress, 64, 78–
89, 94, 107–11; as counselors, 20–21, 97, 79, 87; epideictic, 64; Mary Putnam Ja-
185; response to jeering incident, 197–99. cobi’s, 147; of science, 10
See also medicine Richardson, Ida, 217–19
physicians, women, 147; African American, Richardson, Margaret, 99–104, 108, 159–61
13; and authority, 94, 107–11; distinct Richardson, Ruth, 217
from male physicians, 8–9, 13, 17, 28, 56, Richardson, Thomas, 108
60, 120–21; entry into medicine, 7–8; and Richmond and Louisville Medical Journal,
regularity, 62, 71, 79, 127–31. See also 223
physicians Rivins, Jesse, 109–10
physiology, 203; as popular study, 15, 58–59, Rosenberg, Charles, 86–87
202
Poe, Edgar Allen, 156 Sachs, Oliver, 17
positivism, 174–76 Sale, John, 107–8, 159–61
311
Index
Salpêtrière, 162 Webster, Melissa, 173

Sappol, Michael, 278n74 West, Benjamin, 193
Sawin, Martha, 104–5, 110, 122 Wheeler, Edith Flower, 212
Scarlett, Mary, 50, 53 White, Rebecca, 202
Schaffer, Simon, 11 Wilson, Erasmus, 215–17
Schopenhauer, F., 146 Woman’s Hospital of Pennsylvania, 19, 34,
Scott, Walter, 160–61 61, 237n83; pathological cabinet, 42, 70;
Scribner’s Monthly, 153, 165–66 records of, 41–49, 116, 117–18
Shapin, Steven, 11 Woman’s Medical College of Pennsylvania,
Shermerhorn, Grace, 214 fig. 15 13, 14, 30, 116, 120; Alumnae Association,
Sims, James Marion, 186 31, 113, 123–25, 128–29, 149, 151, 217; an-
Smith, Abram, 209, 247n36 atomical laboratory, 70, 213–15, 216 fig.
socialism, 15, 147, 168, 172 16, 242n48; Board of Lady Managers, 71;
spelling, nonstandard, 246n32 Demonstrator of Anatomy at, 213–15;
sphygmograph, 178 foundation of, 7–8, 126–27; graduation re-
spiritualism, 30–31, 122, 125, 127–28, 146 quirements, 83; and Harriot Hunt, 29; and
Stafford, Barbara, 202 Mary Putnam Jacobi, 150–52; jeering inci-
Still, William, 113 dent at Pennsylvania Hospital, 72, 193–
Stillé, Alfred, 75, 197, 200 212, 269n1, 270n8, 271nn9–11; 272nn16,
Surgeon’s Hall, Edinburgh, 201 18; 273nn 19–20, 22–23; and Hannah
surgery, 117–18, 183, 194, 235n51, 252n82 Longshore, 122, 126–32; and Pennsylvania
State Medical Society, 82; and Philadel-
temperance, 122, 124–25, 127, 131 phia County Medical Society, 26, 113, 193;
theater, 92, 196, 209–11, 260n11 scrapbooks, 208; therapeutic orientation
Therapeutic Society, 149 of, 28; theses from, 83–84, 90–99, 99–104,
Theriot, Nancy, 31 247n37, 249n61; women’s modesty pro-
Thomas, Kersey, 41, 44 tected by, 21, 65
Thomas, Mary Frame Myers, 122 Woman’s Medical College of the New York
Thompsonianism, 6, 29 Infirmary, 149, 151–52, 166, 177, 221 fig.
toasts and replies, 124–25 18
travesty, as writing strategy, 6, 94, 123–45, women: as agents, 157–58, 174, 181; and
147 motherhood, 33–34; separate spheres for,
Truax, Rhoda, 169 4, 64–65, 77–79, 131, 176–77, 186, 224;
tuberculosis, 49, 99–104, 107–8, 118, 159– and silence, 17, 20, 54–55. See also physi-
62, 163 cians, women
Tuskegee Institute, 118 Women’s Christian Temperance Union, 113
Twain, Mark, 223 Wood, George, 108
Woolgar, Steven, 11
Underground Railroad, 73, 122 Wray-Howell, Elizabeth, 214 fig. 15
Upham, Ella, 129
Young, Georgiana, 118–19
Varney-Brownell, Emily, 204–5
Zakrzewska, Marie, 6, 10, 15, 63, 157, 173,
Waitzkin, Howard, 19–20, 236n70 191, 222–23, 224–26, 236n66; childhood,
Wallace, Ellerslie, 25, 27, 33 3–4; medical career, 4; as writer, 5, 36,
Way, Phebe, 104, 105, 110, 122, 252n82 229n1
312

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Out of the Dead House

THE UNIVERSITY OF WISCONSIN PRESS

Printed in the United States of America

Library of Congress Cataloging-in-Publication Data

17 The Human Body and the Library as Sources of

Out of the Dead House

This story rehearses one of the narratives of nineteenth-century women’s

active in radical causes, including abolition, women’s rights, dress reform,

THE CONTEXT: NINETEENTH-CENTURY MEDICINE

Late nineteenth-century medicine is paradigmatic of successful profes-

a quite conventional style of medicine, with no more and no less success

WOMEN PHYSICIANS AND SCIENCE STUDIES

tices of contemporary women scientists. For Evelyn Fox Keller, in Reﬂec-

teenth century as writers, especially as writers of science. If science is under-

WOMEN PHYSICIANS, RHETORIC, AND

My own approach to nineteenth-century women physicians is mediated by

In this book, discussions of individual women physicians and their strategies

for women, to construct a rhetoric which supported women physicians. Her

article. Her work on hysteria mounted a sustained critique of S. Weir Mitch-

Medical Conversations and

Moreover, there was an extremely close correlation between medical con-

guage differently. Very broadly, sociolinguists have identiﬁed no variation in

IMAGINED CONVERSATIONS I: THE DOCTOR’S HOPE

Any analysis of nineteenth-century medical conversations must rely on indi-

In one of his commencement addresses, Woman’s Medical College Dean

We can begin with an example from a prominent male physician at mid-

“But I cannot let you do it.”

No more Laclos; Meigs gives us a Balzacian interior, littered with signs of

contemporary analysis of doctor-patient conversations describes the work of

IMAGINED CONVERSATIONS II: THE HEART HISTORY

Everyone agreed that it was easy to talk to a woman physician. No writer

effect of clinical empiricism or as a response to the competition of sectarians

its emotions, icy conventionalities choked thoughts struggling for expression.

IMAGINED CONVERSATIONS III:

Surviving accounts of the medical conversation are not transparent records

centrality of confession and surveillance in the formation of the early modern

crisis by noticing increased urination. While the doctor experimented with

Patient—Male. Diagnosis. Man habitual drinker suddenly stopping to drink, on

of the conversations between women doctors or medical students and their

July 11th //55 Mrs. M. M. age 32.

The transgressive general diagnosis, “poverty and general illness,” survives

tinctly than any expression of care or connection, a willingness to criticize

in such contemporary charting conventions as “problem-oriented records.” 82

the hospital complaining of paralysis in September 1875; the assistant E. H.

The comparable history of the young epileptic at Jefferson suspends two

AFRICAN AMERICAN WOMEN PHYSICIANS

If gender was a vexed issue in conversations between doctor and patient,

While white physicians could be unwilling to listen to stories of African

But she declared:

We have only fragmentary and indirect accounts of what the work of a

is a valuable source for reconstructing those interactions. Rebecca Lee

I desire to present different subjects by the use of as few technical terms as

Crumpler’s Medical Discourses records her half of the remarkable medical

MEDICAL CONVERSATION AND THE CONSTRUCTION

Medical conversations took place in the presence of the patient’s suffering

of interrogator or refuse the patient’s explanation. Patient and doctor were

sponse enacts her sense of mutual vulnerability and speaks of an ethic of

ORDINARY INSTITUTIONAL WRITING: WOMEN DOCTORS

Preston’s understanding of change, even of revolutionary change, is strategic:

Ladies, we should gain nothing by meeting such as these in argument. Preju-

Despite of opposition, we think it may be truly said, that public sentiment in

In Preston’s 1855 introductory lecture, the argument from progress led,

You will pursue the study of Chemistry. . . .